OnCo
termsTerm

Bridging therapy

aka bridging, bridging chemotherapy, bridging radiotherapy, bridge to CAR-T, bridge to transplant, bridged, holding therapy

Treatment given to keep a fast-growing cancer in check during the weeks between deciding on CAR-T (or transplant) and actually receiving it, while the cells are being manufactured or a donor found.

Aggressive lymphomas and leukaemias can progress or cause organ damage in the 3-6 weeks it takes to manufacture autologous CAR-T cells, so patients often receive bridging chemotherapy, steroids, radiotherapy to bulky sites, or bispecific antibodies; response to bridging and low disease burden at infusion predict better CAR-T outcomes and less CRS. Bridging must avoid drugs that harm T cells before apheresis and be timed so its toxicity has cleared before lymphodepletion. Its necessity is a strong argument for faster manufacturing and off-the-shelf allogeneic products; in the ZUMA-7 trial design, permitting bridging chemotherapy was a point of methodological debate.

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Treatment jargon

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