Induction therapy with the MATRix regimen in patients with newly diagnosed primary diffuse large B-cell lymphoma of the central nervous system - an international study of feasibility and efficacy in routine clinical practice.
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Central Nervous System Neoplasms
/ drug therapy
Combined Modality Therapy
Comorbidity
Consolidation Chemotherapy
Cranial Irradiation
Cytarabine
/ administration & dosage
Female
Hematopoietic Stem Cell Transplantation
Humans
Immunotherapy
Induction Chemotherapy
Internationality
Kaplan-Meier Estimate
Lymphoma, AIDS-Related
/ drug therapy
Lymphoma, Large B-Cell, Diffuse
/ drug therapy
Male
Methotrexate
/ administration & dosage
Middle Aged
Organ Transplantation
Postoperative Complications
/ drug therapy
Progression-Free Survival
Proportional Hazards Models
Rituximab
/ administration & dosage
Thiotepa
/ administration & dosage
IELSG32 trial
MATRix regimen
induction treatment
primary diffuse large B-cell lymphoma of the central nervous system
routine clinical practice
Journal
British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
20
06
2019
accepted:
28
10
2019
pubmed:
31
1
2020
medline:
28
1
2021
entrez:
31
1
2020
Statut:
ppublish
Résumé
The MATRix chemoimmunotherapy regimen is highly effective in patients with newly diagnosed primary diffuse large B-cell lymphoma of the central nervous system (PCNSL). However, nothing is known about its feasibility and efficacy in everyday practice, where patients are more often older/frailer than those enrolled in clinical trials. We conducted a retrospective study addressing tolerability/efficacy of MATRix in 156 consecutive patients with newly diagnosed PCNSL treated outside a clinical trial. Median age and ECOG Performance Status of considered patients were 62 years (range 28-78) and 2 (range 0-4). The overall response rate after MATRix was 79%. Nine (6%) treatment-related deaths were recorded. After a median follow-up of 27.4 months (95% confidence interval [CI] 24.4-31.9%), the two-year progression-free and overall survival were 56% (95% CI 48.4-64.9%) and 64.1% (95% CI 56.7-72.5%) respectively. Patients not eligible for the IELSG32 trial were treated with lower dose intensity and had substantially worse outcomes than those fulfilling inclusion criteria. This is the largest series of PCNSL patients treated with MATRix outside a trial and recapitulates the IELSG32 trial outcomes in the non-trial setting for patients who fit the trial criteria. These data underscore the feasibility and efficacy of MATRix as induction treatment for fit patients in routine practice.
Substances chimiques
Cytarabine
04079A1RDZ
Rituximab
4F4X42SYQ6
Thiotepa
905Z5W3GKH
Methotrexate
YL5FZ2Y5U1
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
879-887Subventions
Organisme : Cancer Research UK
ID : 12115
Pays : United Kingdom
Organisme : Abbvie
Pays : International
Organisme : Gilead
Pays : International
Organisme : Roche
Pays : International
Informations de copyright
© 2020 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.
Références
Abrey, L.E., Yahalom, J. & DeAngelis, L.M. (2000) Treatment for primary CNS lymphoma: the next step. Journal of Clinical Oncology, 18, 3144-3150.
Abrey, L.E., Batchelor, T.T., Ferreri, A.J., Gospodarowicz, M., Pulczynski, E.J., Zucca, E., Smith, J.R., Korfel, A., Soussain, C., DeAngelis, L.M., Neuwelt, E.A., O'Neill, B.P., Thiel, E., Shenkier, T., Graus, F., van den Bent, M., Seymour, J.F., Poortmans, P., Armitage, J.O., Cavalli, F. & International Primary CNS Lymphoma Collaborative Group. (2005) Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma. Journal of Clinical Oncology, 23, 5034-5043.
Abrey, L.E., Ben-Porat, L., Panageas, K.S., Yahalom, J., Berkey, B., Curran, W., Schultz, C., Leibel, S., Nelson, D., Mehta, M. & DeAngelis, L.M. (2006) Primary central nervous system lymphoma: the Memorial Sloan-Kettering Cancer Center prognostic model. Journal of Clinical Oncology, 24, 5711-5715.
Ferreri, A.J., Abrey, L.E., Blay, J.Y., Borisch, B., Hochman, J., Neuwelt, E.A., Yahalom, J., Zucca, E., Cavalli, F., Armitage, J. & Batchelor, T. (2003a) Summary statement on primary central nervous system lymphomas from the Eighth International Conference on Malignant Lymphoma, Lugano, Switzerland, June 12 to 15, 2002. Journal of Clinical Oncology, 21, 2407-2414.
Ferreri, A.J., Blay, J.Y., Reni, M., Pasini, F., Spina, M., Ambrosetti, A., Calderoni, A., Rossi, A., Vavassori, V., Conconi, A., Devizzi, L., Berger, F., Ponzoni, M., Borisch, B., Tinguely, M., Cerati, M., Milani, M., Orvieto, E., Sanchez, J., Chevreau, C., Dell'Oro, S., Zucca, E. & Cavalli, F. (2003b) Prognostic scoring system for primary CNS lymphomas: the International Extranodal Lymphoma Study Group experience. Journal of Clinical Oncology, 21, 266-272.
Ferreri, A.J., Reni, M., Foppoli, M., Martelli, M., Pangalis, G.A., Frezzato, M., Cabras, M.G., Fabbri, A., Corazzelli, G., Ilariucci, F., Rossi, G., Soffietti, R., Stelitano, C., Vallisa, D., Zaja, F., Zoppegno, L., Aondio, G.M., Avvisati, G., Balzarotti, M., Brandes, A.A., Fajardo, J., Gomez, H., Guarini, A., Pinotti, G., Rigacci, L., Uhlmann, C., Picozzi, P., Vezzulli, P., Ponzoni, M., Zucca, E., Caligaris-Cappio, F. & Cavalli, F. & International Extranodal Lymphoma Study Group (IELSG). (2009) High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial. Lancet, 374, 1512-1520.
Ferreri, A.J., Cwynarski, K., Pulczynski, E., Ponzoni, M., Deckert, M., Politi, L.S., Torri, V., Fox, C.P., Rosee, P.L., Schorb, E., Ambrosetti, A., Roth, A., Hemmaway, C., Ferrari, A., Linton, K.M., Ruda, R., Binder, M., Pukrop, T., Balzarotti, M., Fabbri, A., Johnson, P., Gorlov, J.S., Hess, G., Panse, J., Pisani, F., Tucci, A., Stilgenbauer, S., Hertenstein, B., Keller, U., Krause, S.W., Levis, A., Schmoll, H.J., Cavalli, F., Finke, J., Reni, M., Zucca, E., Illerhaus, G. & International Extranodal Lymphoma Study Group (IELSG). (2016) Chemoimmunotherapy with methotrexate, cytarabine, thiotepa, and rituximab (MATRix regimen) in patients with primary CNS lymphoma: results of the first randomisation of the International Extranodal Lymphoma Study Group-32 (IELSG32) phase 2 trial. The Lancet Haematology, 3, e217-27.
Ferreri, A.J.M., Cwynarski, K., Pulczynski, E., Fox, C.P., Schorb, E., La Rosee, P., Binder, M., Fabbri, A., Torri, V., Minacapelli, E., Falautano, M., Ilariucci, F., Ambrosetti, A., Roth, A., Hemmaway, C., Johnson, P., Linton, K.M., Pukrop, T., Sonderskov Gorlov, J., Balzarotti, M., Hess, G., Keller, U., Stilgenbauer, S., Panse, J., Tucci, A., Orsucci, L., Pisani, F., Levis, A., Krause, S.W., Schmoll, H.J., Hertenstein, B., Rummel, M., Smith, J., Pfreundschuh, M., Cabras, G., Angrilli, F., Ponzoni, M., Deckert, M., Politi, L.S., Finke, J., Reni, M., Cavalli, F., Zucca, E., Illerhaus, G. & International Extranodal Lymphoma Study Group (IELSG). (2017) Whole-brain radiotherapy or autologous stem-cell transplantation as consolidation strategies after high-dose methotrexate-based chemoimmunotherapy in patients with primary CNS lymphoma: results of the second randomisation of the International Extranodal Lymphoma Study Group-32 phase 2 trial. The Lancet Haematology, 4, e510-e523.
Glass, J., Won, M., Schultz, C.J., Brat, D., Bartlett, N.L., Suh, J.H., Werner-Wasik, M., Fisher, B.J., Liepman, M.K., Augspurger, M., Bokstein, F., Bovi, J.A., Solhjem, M.C. & Mehta, M.P. (2016) Phase I and II study of induction chemotherapy with methotrexate, rituximab, and temozolomide, followed by whole-brain radiotherapy and postirradiation temozolomide for primary CNS lymphoma: NRG oncology RTOG 0227. Journal of Clinical Oncology, 34, 1620-1625.
Gupta, N.K., Nolan, A., Omuro, A., Reid, E.G., Wang, C.C., Mannis, G., Jaglal, M., Chavez, J.C., Rubinstein, P.G., Griffin, A., Abrams, D.I., Hwang, J., Kaplan, L.D., Luce, J.A., Volberding, P., Treseler, P.A. & Rubenstein, J.L. (2017) Long-term survival in AIDS-related primary central nervous system lymphoma. Neuro-Oncology, 19, 99-108.
Haldorsen, I.S., Krossnes, B.K., Aarseth, J.H., Scheie, D., Johannesen, T.B., Mella, O. & Espeland, A. (2007) Increasing incidence and continued dismal outcome of primary central nervous system lymphoma in Norway 1989-2003: time trends in a 15-year national survey. Cancer, 110, 1803-1814.
Kasenda, B., Ferreri, A.J., Marturano, E., Forst, D., Bromberg, J., Ghesquieres, H., Ferlay, C., Blay, J.Y., Hoang-Xuan, K., Pulczynski, E.J., Fossa, A., Okoshi, Y., Chiba, S., Fritsch, K., Omuro, A., O'Neill, B.P., Bairey, O., Schandelmaier, S., Gloy, V., Bhatnagar, N., Haug, S., Rahner, S., Batchelor, T.T., Illerhaus, G. & Briel, M. (2015) First-line treatment and outcome of elderly patients with primary central nervous system lymphoma (PCNSL)-a systematic review and individual patient data meta-analysis. Annals of Oncology, 26, 1305-1313.
Makino, K., Nakamura, H., Kino, T., Takeshima, H. & Kuratsu, J. (2006) Rising incidence of primary central nervous system lymphoma in Kumamoto, Japan. Surgical Neurology, 66, 503-506.
Morris, P.G., Correa, D.D., Yahalom, J., Raizer, J.J., Schiff, D., Grant, B., Grimm, S., Lai, R.K., Reiner, A.S., Panageas, K., Karimi, S., Curry, R., Shah, G., Abrey, L.E., DeAngelis, L.M. & Omuro, A. (2013) Rituximab, methotrexate, procarbazine, and vincristine followed by consolidation reduced-dose whole-brain radiotherapy and cytarabine in newly diagnosed primary CNS lymphoma: final results and long-term outcome. Journal of Clinical Oncology, 31, 3971-3979.
Moulignier, A., Lamirel, C., Picard, H., Lebrette, M.G., Amiel, C., Hamidi, M., Polivka, M., Mikol, J., Cochereau, I. & Pialoux, G. (2017) Long-term AIDS-related PCNSL outcomes with HD-MTX and combined antiretroviral therapy. Neurology, 89, 796-804.
Rubenstein, J., Ferreri, A.J. & Pittaluga, S. (2008) Primary lymphoma of the central nervous system: epidemiology, pathology and current approaches to diagnosis, prognosis and treatment. Leukaemia & Lymphoma, 49, 43-51.
Rubenstein, J.L., Hsi, E.D., Johnson, J.L., Jung, S.H., Nakashima, M.O., Grant, B., Cheson, B.D. & Kaplan, L.D. (2013) Intensive chemotherapy and immunotherapy in patients with newly diagnosed primary CNS lymphoma: CALGB 50202 (Alliance 50202). Journal of Clinical Oncology, 31, 3061-3068.
Schemper, M. & Smith, T.L. (1996) A note on quantifying follow-up in studies of failure time. Controlled Clinical Trials, 17, 343-346.
Schorb, E., Kasenda, B., Atta, J., Kaun, S., Morgner, A., Hess, G., Elter, T., von Bubnoff, N., Dreyling, M., Ringhoffer, M., Krause, S.W., Derigs, G., Klimm, B., Niemann, D., Fritsch, K., Finke, J. & Illerhaus, G. (2013) Prognosis of patients with primary central nervous system lymphoma after high-dose chemotherapy followed by autologous stem cell transplantation. Haematologica, 98, 765-770.
Schorb, E., Finke, J., Ferreri, A.J., Ihorst, G., Mikesch, K., Kasenda, B., Fritsch, K., Fricker, H., Burger, E., Grishina, O., Valk, E., Zucca, E. & Illerhaus, G. (2016) High-dose chemotherapy and autologous stem cell transplant compared with conventional chemotherapy for consolidation in newly diagnosed primary CNS lymphoma-a randomized phase III trial (MATRix). BMC Cancer, 16, 282.
Zeremski, V., Koehler, M., Fischer, T. & Schalk, E. (2016) Characteristics and outcome of patients with primary CNS lymphoma in a "real-life" setting compared to a clinical trial. Annals of Hematology, 95, 793-799.