BACKGROUND: Standard salvage therapy has not been established for recurrent primary central nervous system lymphoma (PCNSL). We report the final results of a prospective study on topotecan chemotherapy in relapsed or refractory PCNSL. PATIENTS AND METHODS: The study included 27 patients with a median age of 51 years and an ECOG performance status of 2. Fourteen patients were refractory to the last therapy, and 13 relapsed after a median period of 6.0 months. Pretreatment with up to four regimens included chemotherapy in 26 patients and whole brain irradiation in 14. A 30-min daily topotecan infusion of 1.5 mg/m(2) for 5 days was repeated every 3 weeks. RESULTS: The response rate was 33% with five complete (CR) and four partial remissions (PR). The median follow-up was 37.7 months. All complete responders had sustained remissions lasting for 9 to 28 months. The median event-free survival (EFS) was 2.0 months (9.1 months in responders), the overall survival (OAS) was 8.4 months. CTC grade 3-4 leukopenia occurred in 26% and thrombocytopenia in 11% of the patients. Eight of 12 patients alive without cerebral lymphoma > or = six months after topotecan exhibited deficits attributable to late neurotoxicity. CONCLUSION: Topotecan as monotherapy is active in relapsed and refractory PCNSL with tolerable toxicity.
BACKGROUND: Standard salvage therapy has not been established for recurrent primary central nervous system lymphoma (PCNSL). We report the final results of a prospective study on topotecan chemotherapy in relapsed or refractory PCNSL. PATIENTS AND METHODS: The study included 27 patients with a median age of 51 years and an ECOG performance status of 2. Fourteen patients were refractory to the last therapy, and 13 relapsed after a median period of 6.0 months. Pretreatment with up to four regimens included chemotherapy in 26 patients and whole brain irradiation in 14. A 30-min daily topotecan infusion of 1.5 mg/m(2) for 5 days was repeated every 3 weeks. RESULTS: The response rate was 33% with five complete (CR) and four partial remissions (PR). The median follow-up was 37.7 months. All complete responders had sustained remissions lasting for 9 to 28 months. The median event-free survival (EFS) was 2.0 months (9.1 months in responders), the overall survival (OAS) was 8.4 months. CTC grade 3-4 leukopenia occurred in 26% and thrombocytopenia in 11% of the patients. Eight of 12 patients alive without cerebral lymphoma > or = six months after topotecan exhibited deficits attributable to late neurotoxicity. CONCLUSION:Topotecan as monotherapy is active in relapsed and refractory PCNSL with tolerable toxicity.
Authors: Jorg Dietrich; Laura Versmee; Jan Drappatz; April F Eichler; Lakshmi Nayak; Andrew Norden; Eric Wong; Michelle R Pisapia; SooAe S Jones; Amanda B Gordon; Bruce A Chabner; Fred Hochberg; Tracy T Batchelor Journal: Oncologist Date: 2020-07-01
Authors: Christian Grommes; Alessandro Pastore; Nicolaos Palaskas; Sarah S Tang; Carl Campos; Derrek Schartz; Paolo Codega; Donna Nichol; Owen Clark; Wan-Ying Hsieh; Dan Rohle; Marc Rosenblum; Agnes Viale; Viviane S Tabar; Cameron W Brennan; Igor T Gavrilovic; Thomas J Kaley; Craig P Nolan; Antonio Omuro; Elena Pentsova; Alissa A Thomas; Elina Tsyvkin; Ariela Noy; M Lia Palomba; Paul Hamlin; Craig S Sauter; Craig H Moskowitz; Julia Wolfe; Ahmet Dogan; Minhee Won; Jon Glass; Scott Peak; Enrico C Lallana; Vaios Hatzoglou; Anne S Reiner; Philip H Gutin; Jason T Huse; Katherine S Panageas; Thomas G Graeber; Nikolaus Schultz; Lisa M DeAngelis; Ingo K Mellinghoff Journal: Cancer Discov Date: 2017-06-15 Impact factor: 39.397