# Bridging therapy

Source: https://onco.cc/terms/bridging-therapy/  
OnCo record `bridging-therapy` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Summary

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.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: bridging; bridging chemotherapy; bridging radiotherapy; bridge to CAR-T; bridge to transplant; bridged; holding therapy

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Chimeric_antigen_receptor_T_cell
- Wikipedia: https://en.wikipedia.org/wiki/Chimeric_antigen_receptor_T_cell

## Connected records

- terms: [Apheresis (leukapheresis)](https://onco.cc/terms/apheresis/), [Lymphodepletion before CAR-T](https://onco.cc/terms/lymphodepletion/), [Salvage therapy](https://onco.cc/terms/salvage-therapy/), [Vein-to-vein time and manufacturing slots](https://onco.cc/terms/vein-to-vein-time/)
- fronts: [Cell Therapy](https://onco.cc/fronts/cell-therapy/)
- technologies: [Allogeneic (off-the-shelf) cell therapy](https://onco.cc/technologies/allogeneic-cell-therapy/), [CAR-T cell therapy](https://onco.cc/technologies/car-t/)
- trials: [JULIET](https://onco.cc/trials/juliet/), [ZUMA-7](https://onco.cc/trials/zuma-7/)
- key papers: [Second-line tisagenlecleucel or standard care in aggressive B-cell lymphoma](https://onco.cc/key-papers/paper-belinda-tisagenlecleucel-second-line-nejm-2022/)
- ideas: [Report the time from apheresis to infusion as a trial endpoint, not a logistics footnote](https://onco.cc/ideas/lymphoma-ev-manufacturing-time-as-a-trial-endpoint/)
- cancers: [Early hepatocellular carcinoma (BCLC 0 and A)](https://onco.cc/cancers/hcc-early/), [Intermediate hepatocellular carcinoma (BCLC B)](https://onco.cc/cancers/hcc-intermediate/)

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