Epidemiologic Characteristics, Prognostic Factors, and Treatment Outcomes in Primary Central Nervous System Lymphoma: A SEER-Based Study

Tang, Dongsheng; Chen, Yue; Shi, Yuye; Hong, Tzung-Pei; Tao, Shandong; Zhang, Quan’e; Ding, Banghe; He, Zhengmei; Yu, Liang

doi:10.3389/fonc.2022.817043

Cited by 13 publications

(8 citation statements)

References 40 publications

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“…As important social demographic variables, sex and race were usually considered in previous studies to personalize the treatment of cancer. In line with our results, a recent study showed that sex and race are prognostic factors for OS ( 22 ). However, it did not mention the effect on NCSS.…”

Section: Discussionsupporting

confidence: 93%

Non-cancer-specific survival in patients with primary central nervous system lymphoma: A multi-center cohort study

Chi

Zhou²,

Luo³

et al. 2023

Front. Oncol.

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ObjectiveThe study aimed to evaluate the non-cancer-specific death risk and identify the risk factors affecting the non-cancer-specific survival (NCSS) in patients with primary central nervous system lymphoma (PCNSL).MethodsThis multi-center cohort study included 2497 patients with PCNSL in the Surveillance, Epidemiology and End Results (SEER) database from 2007 to 2016, with a mean follow-up of 4.54 years. The non-cancer-specific death risk in patients with PCNSL and primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) was evaluated using the proportion of deaths, standardized mortality ratio (SMR), and absolute excess risk (AER). Univariate and multivariate competing risk regression models were utilized to identify the risk factors of NCSS.ResultsPCNSL was the most frequent cause of death in PCNSL patients (75.03%). Non-cancer-specific causes constituted a non-negligible portion of death (20.61%). Compared with the general population, PCNSL patients had higher risks of death from cardiovascular disease (CVD) (SMR, 2.55; AER, 77.29), Alzheimer’s disease (SMR, 2.71; AER, 8.79), respiratory disease (SMR, 2.12; AER, 15.63), and other non-cancer-specific diseases (SMR, 4.12; AER, 83.12). Male sex, Black race, earlier year of diagnosis (2007–2011), being unmarried, and a lack of chemotherapy were risk factors for NCSS in patients with PCNSL and PCNS-DLBCL (all P < 0.05).ConclusionNon-cancer-specific causes were important competing causes of death in PCNSL patients. More attention is recommended to non-cancer-specific causes of death in the management of PCNSL patients.

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Section: Discussionsupporting

confidence: 93%

Non-cancer-specific survival in patients with primary central nervous system lymphoma: A multi-center cohort study

Chi

Zhou²,

Luo³

et al. 2023

Front. Oncol.

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“…Even so, the elderly patients comprised most of our cohort with 68% of patients older than 60 years and 36% above the age of 70, which is also in line with several previous population-based reports. 4,14 The current treatment standard for newly diagnosed PCNSL is HD-MTX-based immunochemotherapy. 5,6,15 This standard has been accomplished in most patients of this study as 90% of the cohort were treated with HD-MTX-combination therapy.…”

Section: Discussionmentioning

confidence: 99%

“…3 Elderly patients, aged 60 and above, comprise up to 65% of all PCNSL patients. 4 The treatment of PCNSL is challenging as the presence of the blood-brain barrier limits the scope of therapeutic agents that can penetrate the brain and attain therapeutic drug concentrations.…”

Section: Introductionmentioning

confidence: 99%

A retrospective study of 222 patients with newly diagnosed primary central nervous system lymphoma—Outcomes indicative for improved survival overtime

Bairey

Lebel

Buxbaum

et al. 2023

Hematological Oncology

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Primary central nervous system lymphoma (PCNSL) is a rare disease with an incidence of 0.4/per 100,000 person‐years. As there is a limited number of prospective randomized trials in PCNSL, large retrospective studies on this rare disease may yield information that might prove useful for the future design of randomized clinical trials. We retrospectively analyzed the data of 222 newly diagnosed PCNSL patients treated in five referral centers in Israel between 2001 and 2020. During this period, combination therapy became the treatment of choice, rituximab has been added to the induction therapy, and consolidation with irradiation was largely laid off and was mostly replaced by high‐dose chemotherapy with or without autologous stem cell transplantation (HDC‐ASCT). Patients older than 60 comprised 67.5% of the study population. First‐line treatment included high‐dose methotrexate (HD‐MTX) in 94% of patients with a median MTX dose of 3.5 g/m2 (range 1.14–6 g/m2) and a median cycle number of 5 (range 1–16). Rituximab was given to 136 patients (61%) and consolidation treatment to 124 patients (58%). Patients treated after 2012 received significantly more treatment with HD‐MTX and rituximab, more consolidation treatments, and autologous stem cell transplantation. The overall response rate was 85% and the complete response (CR)/unconfirmed CR rate was 62.1%. After a median follow‐up of 24 months, the median progression‐free survival (PFS) and overall survival (OS) were 21.9 and 43.5 months respectively with a significant improvement since 2012 (PFS: 12.5 vs. 34.2 p = 0.006 and OS: 19.9 vs. 77.3 p = 0.0003). A multivariate analysis found that the most important factors related to OS were obtaining a CR followed by rituximab treatment and Eastern Cooperative Oncology Group performance status. The observed improvement in outcomes may be due to multiple components such as an intention to treat all patients regardless of age with HD‐MTX‐based combination chemotherapy, treatment in dedicated centers, and more aggressive consolidation with the introduction of HDC‐ASCT.

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“…Most PCNSLs (over 90%) are histologically classified as DLBCL, followed by rare Burkitt, lymphoblastic T-cell and low-grade lymphomas ( 23 , 24 ). Imaging choice in brain tumor including magnetic resonance imaging (MRI) or 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is crucial for diagnosis and surgical planning ( 25 , 26 ).…”

Section: Introductionmentioning

confidence: 99%

Bruton’s tyrosine kinase inhibitors in the treatment of primary central nervous system lymphoma: A mini-review

Shen

Liu

2022

Front. Oncol.

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Primary central nervous system lymphoma (PCNSL) is a highly aggressive brain tumor with poor prognosis if no treatment. The activation of the NF-κB (nuclear factor kappa-B) is the oncogenic hallmark of PCNSL, and it was driven by B cell receptor (BCR) and Toll-like receptor (TLR) signaling pathways. The emergence of Bruton’s tyrosine kinase inhibitors (BTKis) has brought the dawn of life to patients with PCNSL. This review summarizes the management of PCNSL with BTKis and potential molecular mechanisms of BTKi in the treatment of PCNSL. And the review will focus on the clinical applications of BTKi in the treatment of PCNSL including the efficacy and adverse events, the clinical trials currently being carried out, the underlying mechanisms of resistance to BTKi and possible solutions to drug resistance.

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Epidemiologic Characteristics, Prognostic Factors, and Treatment Outcomes in Primary Central Nervous System Lymphoma: A SEER-Based Study

Cited by 13 publications

References 40 publications

Non-cancer-specific survival in patients with primary central nervous system lymphoma: A multi-center cohort study

Non-cancer-specific survival in patients with primary central nervous system lymphoma: A multi-center cohort study

A retrospective study of 222 patients with newly diagnosed primary central nervous system lymphoma—Outcomes indicative for improved survival overtime

Bruton’s tyrosine kinase inhibitors in the treatment of primary central nervous system lymphoma: A mini-review

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