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- W1551145897 abstract "OBJECTIVE: We here report on the tolerability and efficacy of induction therapy with methotrexate (MTX), temozolomide (TMZ) and rituximab (RTX) in a series of 18 PCNSL patients age 60 and above. BACKGROUND: Treatment of PCNSL in elderly patients has not been well established and management can be challenging due to limited tolerance of chemotherapy and worse disease prognosis. DESIGN/METHODS: From 2007-2012, 18 PCNSL patients age ≥ 60 years received MRT induction. Median age at diagnosis was 69 (60-83). Induction therapy consisted of high-dose MTX at 3.5-8 g/m2 (days 1, 15), RTX at 375 mg/m2 (days 3, 10, 17, 24) and TMZ at 150 mg/m2 (days 7-11) of each 28-day cycle. MTX was given every 2 weeks until complete response (CR), RTX weekly for a total of 6 doses, and TMZ monthly until CR. Monthly MRI was used to assess response. Consolidation included two additional MTX cycles, followed by monthly maintenance MTX with or without TMZ, or autologous stem cell transplantation. RESULTS: CR was achieved in 14/18 (78%) patients at a median of 4 months. 3/18 patients achieved partial response (PR). One patient had early progressive disease (PD) and died 11 months after treatment onset. At a median follow-up of 15.5 months from treatment initiation, 10/18 patients remain in CR, 2/18 patients continue to receive induction MRT, 5/18 developed relapse or progressive disease. One patient in CR died from complications unrelated to PCNSL. Median PFS has not been reached. MRT induction was well tolerated; significant toxicities included reversible grade 3 transaminitis (3/18), reversible grade 1-2 serum creatinine elevation (6/18), and ≥ grade 3 hematologic toxicity (3/18). CONCLUSIONS: In elderly patients with newly diagnosed PCNSL, MRT induction is well tolerated and associated with a high response rate. Our experience suggests that this regimen is safe and effective in this patient population. Disclosure: Dr. Forst has nothing to disclose. Dr. Chi has received research support from Pfizer Inc. Dr. Dietrich has nothing to disclose. Dr. Gerstner has nothing to disclose. Dr. Jones has nothing to disclose. Dr. Byrne has nothing to disclose. Dr. Hochberg has nothing to disclose. Dr. Plotkin has received research support from Pfizer. Dr. Batchelor has received personal compensation for activities with Merck & Co., Inc., Roche Diagnostics, Kirin Pharmaceuticals, Up To Date, Inc., Robert Michael Educational Institute, LLC, Educational Concepts Group, Oakstone Medical Publishing, American Society of Hematology, Champions Biotechnology, and Advance Medical. Dr. Batchelor has received research support from Pfizer, Inc., AstraZeneca Pharmaceuticals, and Millenium." @default.
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- W1551145897 date "2013-02-12" @default.
- W1551145897 modified "2023-09-22" @default.
- W1551145897 title "Methotrexate, Rituximab, Temozolomide (MRT) Induction Therapy for Elderly Patients with Primary Central Nervous System Lymphoma (PCNSL) (IN10-1.002)" @default.
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