K Fritsch1, B Kasenda1, C Hader2, G Nikkhah3, M Prinz4, V Haug1, S Haug1, G Ihorst1, J Finke1, G Illerhaus5. 1. Department of Hematology and Oncology. 2. Department of Neuroradiology. 3. Department of Stereotactic and Functional Neurosurgery. 4. Department of Neuropathology, Freiburg University Medical Center, Freiburg, Germany. 5. Department of Hematology and Oncology. Electronic address: gerald.illerhaus@uniklinik-freiburg.de.
Abstract
BACKGROUND: Primary central nervous system lymphoma (PCNSL) is an aggressive extranodal non-Hodgkin lymphoma confined to the central nervous system. In this article, we report the results of a pilot trial adding rituximab to the established regimen consisting of methotrexate, procarbazine, and lomustine (R-MCP). DESIGN AND METHODS: PCNSL patients ≥65 years without Karnofsky performance score (KPS) limit were included. R-MCP regimen consisted of rituximab (375 mg/m(2) i.v. on days -6, 1, 15, and 29), methotrexate (3 g/m(2) i.v., days 2, 16, and 30) followed by folinic rescue, procarbazine (60 mg/m(2) orally, days 2-11), and lomustine (110 mg/m(2) orally, day 2). A maximum of three 43-day cycles were applied. Primary end point was response to treatment obtained by magnetic resonance imaging. Secondary end points were overall survival (OS) and progression-free survival (PFS). RESULTS: Twenty-eight patients were included (median age 75, median KPS 60%). Best documented response: complete remission in 18 of 28 (64%), partial remission in 5 of 28 (18%), stable disease in 1 of 28 (4%), and progressive disease in 2 of 28 (7%) patients. Response was not assessed in two patients. Two treatment-associated deaths were observed. After a median follow-up of 36 months, the 3-year PFS and OS was 31%. CONCLUSION: R-MCP regimen is well tolerated and active in elderly patients with newly diagnosed PCNSL.
BACKGROUND:Primary central nervous system lymphoma (PCNSL) is an aggressive extranodal non-Hodgkin lymphoma confined to the central nervous system. In this article, we report the results of a pilot trial adding rituximab to the established regimen consisting of methotrexate, procarbazine, and lomustine (R-MCP). DESIGN AND METHODS: PCNSLpatients ≥65 years without Karnofsky performance score (KPS) limit were included. R-MCP regimen consisted of rituximab (375 mg/m(2) i.v. on days -6, 1, 15, and 29), methotrexate (3 g/m(2) i.v., days 2, 16, and 30) followed by folinic rescue, procarbazine (60 mg/m(2) orally, days 2-11), and lomustine (110 mg/m(2) orally, day 2). A maximum of three 43-day cycles were applied. Primary end point was response to treatment obtained by magnetic resonance imaging. Secondary end points were overall survival (OS) and progression-free survival (PFS). RESULTS: Twenty-eight patients were included (median age 75, median KPS 60%). Best documented response: complete remission in 18 of 28 (64%), partial remission in 5 of 28 (18%), stable disease in 1 of 28 (4%), and progressive disease in 2 of 28 (7%) patients. Response was not assessed in two patients. Two treatment-associated deaths were observed. After a median follow-up of 36 months, the 3-year PFS and OS was 31%. CONCLUSION: R-MCP regimen is well tolerated and active in elderly patients with newly diagnosed PCNSL.
Authors: B Kasenda; A J M Ferreri; E Marturano; D Forst; J Bromberg; H Ghesquieres; C Ferlay; J Y Blay; K Hoang-Xuan; E J Pulczynski; A Fosså; Y Okoshi; S Chiba; K Fritsch; A Omuro; B P O'Neill; O Bairey; S Schandelmaier; V Gloy; N Bhatnagar; S Haug; S Rahner; T T Batchelor; G Illerhaus; M Briel Journal: Ann Oncol Date: 2015-02-20 Impact factor: 32.976
Authors: Patrick G Morris; Denise D Correa; Joachim Yahalom; Jeffrey J Raizer; David Schiff; Barbara Grant; Sean Grimm; Rose K Lai; Anne S Reiner; Kathy Panageas; Sasan Karimi; Richard Curry; Gaurav Shah; Lauren E Abrey; Lisa M DeAngelis; Antonio Omuro Journal: J Clin Oncol Date: 2013-10-07 Impact factor: 44.544