Efficacy and safety of high-dose etoposide cytarabine as consolidation following rituximab methotrexate temozolomide induction in newly diagnosed primary central nervous system lymphoma in immunocompetent patients

Birsen, Rudy; Willems, Lise; Pallud, Johan; Blanc, Estelle; Burroni, Barbara; Legoff, Marielle; Ray, Emmanuelle Le; Pilorge, Sylvain; Deau, Bénédicte; Franchi, Patricia; Vignon, Marguerite; Kirova, Yulia; Edjlali, Myriam; Houillier, Caroline; Soussain, Carole; Varlet, Pascale; Dezamis, Edouard; Damotte, Diane; Bouscary, Didier; Tamburini, Jérôme

doi:10.3324/haematol.2017.185843

Cited by 26 publications

(24 citation statements)

References 15 publications

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“…NK-T-PCNSL? Third, the best choice for the consolidation therapy is still uncertain but selecting either conventional chemotherapy, ASCT, WBRT, or CAR T treatment is crucial (91,92). Fourth, there is still no goldstandard comprehensive evaluation system for the treatment effects.…”

Section: Conclusion and Future Challengesmentioning

confidence: 99%

Recent Progress on Primary Central Nervous System Lymphoma—From Bench to Bedside

Shao

et al. 2021

Front. Oncol.

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Primary central nervous system lymphoma (PCNSL) is a rare subtype of extra-nodal lymphoma. The high relapse rate of PCNSL remains a major challenge to the hematologists, even though patients exhibit high sensitivity to the methotrexate-based chemotherapeutic regimens. Recently, the advent of Bruton’s tyrosine kinase inhibitor (BTKi) and CAR T treatment has made more treatment options available to a proportion of patients. However, whether BTKi monotherapy should be given alone or in combination with conventional chemotherapy is still a clinical question. The status of CAR T therapy for PCNSLs also needs to be elucidated. In this review, we summarized the latest progress on the epidemiology, pathology, clinical manifestation, diagnosis, and treatment options for PCNSLs.

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Section: Conclusion and Future Challengesmentioning

confidence: 99%

Recent Progress on Primary Central Nervous System Lymphoma—From Bench to Bedside

Shao

et al. 2021

Front. Oncol.

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“…These encouraging results were confirmed in an independent single-center series of 28 consecutive newly diagnosed patients with PCNSL, including a majority of older patients. However, EA was much more toxic than previously reported, especially regarding the length of neutropenia and related infectious complications [ 85 ].…”

Section: Treatmentmentioning

confidence: 99%

Primary Central Nervous System Lymphoma in Elderly Patients: Management and Perspectives

Morales-Martínez¹,

Lozano-Sanchez²,

Durán-Peña³

et al. 2021

Cancers

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The management of elderly patients suffering from primary central nervous system (CNS) lymphoma, who represent a rapidly growing population, is challenging. Despite the advances made in PCNSL treatment, the prognosis in older patients remains unsatisfactory. The high risk of systemic and CNS toxicity induced by a high-dose chemotherapy regimen and radiation therapy, respectively, limits the use of consolidation phase treatments in elderly patients and contributes to the poor outcome of these patients. Here, we review the current treatment strategies and ongoing trials proposed for elderly PCNSL patients.

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“…Notably, the rate of treatmentrelated death mounted to 14.4%. Another phase II study used intensive chemotherapy protocol that included consolidation with HD etoposide plus cytarabine that followed an induction with rituximab, HD-MTX, and temozolomide [21,39]. The study accrued 44 patients of all ages with 23 of them aged >60 years.…”

Section: Consolidation With Non-myeloablative Hd Chemotherapymentioning

confidence: 99%

Consolidation Treatment for Primary Central Nervous System Lymphoma: Which Modality for Whom?

Bairey¹,

Shargian²,

Siegal³

2020

Acta Haematol

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Primary central nervous system lymphoma is a rare aggressive disease that largely affects elderly patients and is associated with poor prognosis. The optimal treatment approach is not yet defined and it consists of induction and consolidation phases. The combination of high-dose (HD) methotrexate-based chemotherapy followed by whole-brain radiotherapy (WBRT) prolongs the median progression-free survival (PFS) and overall survival 2- to 3-fold as compared to WBRT alone but is associated with significant delayed neurotoxicity. Alternative strategies are being investigated in order to improve disease outcomes and spare patients the neurocognitive side effects. These include reduced-dose WBRT, non-myeloablative HD chemotherapy, or HD chemotherapy with autologous stem cell transplantation (HDC/ASCT). There are no randomized studies that compare all these consolidation regimens head to head but recently HDC/ASCT has been evaluated versus WBRT in prospective randomized studies. These studies proved that WBRT and HDC/ASCT yield similar 2-year PFS with preserved or improved cognitive function after HDC/ASCT. Yet, the proportion of patients treated with such intensive consolidation is low, both in real life and in specialized centers, leaving many unsettled issues. This review is appraising current dilemmas related to the choice of consolidating therapeutic modalities, their associated acute and delayed toxicity, and future prospects for alternative approaches in the elderly.

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Efficacy and safety of high-dose etoposide cytarabine as consolidation following rituximab methotrexate temozolomide induction in newly diagnosed primary central nervous system lymphoma in immunocompetent patients

Cited by 26 publications

References 15 publications

Recent Progress on Primary Central Nervous System Lymphoma—From Bench to Bedside

Recent Progress on Primary Central Nervous System Lymphoma—From Bench to Bedside

Primary Central Nervous System Lymphoma in Elderly Patients: Management and Perspectives

Consolidation Treatment for Primary Central Nervous System Lymphoma: Which Modality for Whom?

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