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Summary: Radiotherapy (RT) has potential synergistic effects with chimeric antigen receptor (CAR) T but is not widely used as bridging therapy due to logistical challenges and lack of standardised protocols. We analysed RT bridging in a multicentre national cohort of large B‐cell lymphoma patients approved for 3L axicabtagene ciloleucel or tisagenlecleucel across 12 UK centres. Of 763 approved patients, 722 were leukapheresed, 717 had data available on bridging therapy. 169/717 (24%) received RT bridging, 129 as single modality and 40 as combined modality treatment (CMT). Of 169 patients, 65.7% had advanced stage, 36.9% bulky disease, 86.5% elevated LDH, 41.7% international prognostic index (IPI) ≥3 and 15.2% double/triple hit at the time of approval. Use of RT bridging varied from 11% to 32% between centres and increased over time. Vein‐to‐vein time and infusion rate did not differ between bridging modalities. RT‐bridged patients had favourable outcomes with 1‐year progression‐free survival (PFS) of 56% for single modality and 47% for CMT (1‐year PFS 43% for systemic bridging). This is the largest cohort of LBCL patients receiving RT bridging prior to CAR T reported to date. Our results show that RT bridging can be safely and effectively used even in advanced stage and high‐risk disease, with low dropout rates and excellent outcomes. [ABSTRACT FROM AUTHOR]

Summary: The success of CD19 Chimeric antigen receptor (CAR) T‐cell therapy in large B‐cell lymphoma (LBCL) has been partially offset by toxicity and logistical challenges, which off‐the‐shelf agents like CD20xCD3 bispecific antibodies might potentially overcome. However, when using CAR T outcomes as the ʽstandard‐of‐care comparator̕ for relapsed/refractory (r/r) LBCL, a potential learning curve with implementing a novel, complex therapy like CAR T needs to be considered. To address this, we analysed 726 UK patients intended to be treated with CD19 CAR T for r/r LBCL and compared outcomes between the first year of the national CAR T programme (Era 1; 2019) and the more recent treatment era (Era 2; 2020–2022). We identified significant improvements for Era 2 versus Era 1 in dropout rate (17% vs. 27%, p = 0.001), progression‐free survival (1‐year PFS 50% vs. 32%, p < 0.001) and overall survival (1‐year OS 60% vs. 40%, p < 0.001). We also observed increased use of bridging therapy, improvement in bridging outcomes, more tocilizumab/corticosteroid use, reduced high‐grade cytokine release syndrome (4% vs. 9%, p = 0.01) and intensive care unit admissions (20% vs. 32%, p = 0.001). Our results demonstrate significant improvement in CAR T outcomes over time, highlighting the importance of using up‐to‐date clinical data when comparing CAR T against new treatment options for r/r LBCL. [ABSTRACT FROM AUTHOR]

High-precision, individualised RT protocols allowed successful tumour de-bulking with limited toxicity, providing the basis to develop specific RT bridging protocols in lymphoma. RADIOTHERAPY BRIDGING IN LARGE B-CELL LYMPHOMA PATIENTS RECEIVING CD19 CAR-T - THE UK EXPERIENCE B Background: b Radiotherapy (RT) has potential synergistic effects with CAR T but is not widely used as bridging therapy for lymphoma patients due to logistical challenges, uncertainty about patient selection and lack of standardised protocols. [Extracted from the article]

Keypoints • Involving patients and parents in the choice of their cochlear implant encourages an active role in the process and facilitates ‘bonding’ and ‘ownership’ of the device. • The most frequent reasons given by patients for selecting a device included cochlear implant comfort and appearance. • We describe the Implant Programme based at the Royal National Throat, Nose and Ear Hospital, London, and also examine patient satisfaction with the scheme. [ABSTRACT FROM AUTHOR]

Self-recording procedures were used by four adolescent girls to increase work and comments (cues) that evoked staff praise during vocational training sessions in a maximum-security institution for offenders. The girls were selected on the basis of their not responding to a staff-directed token program. The self-recording procedures were directed by a therapist who saw the girls outside the vocational training sessions. According to a multiple-baseline design, self-recording of work was introduced sequentially to each of the two or three settings the girls attended each day. A few days after work had increased, self-recording of cues was introduced. Tokens were delivered by the therapist for work and cues recorded by the girls. Work and cues increased following self-recording for three of the girls and increased cues evoked higher rates of staff praise. Girl and staff behaviors were maintained during short follow-up periods when tokens were not given for the girls' records. The procedures failed to effect desirable changes with a fourth girl's work and self-recording of work was terminated without introducing cueing.