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• W3174228889 abstract "Introduction: The MATRix regimen (methotrexate, cytarabine, thiotepa, rituximab) significantly improved outcome of patients (pts) with primary CNS lymphoma (PCNSL) enrolled in the IELSG32 trial. At a median follow-up of 40 months, both whole-brain irradiation (WBRT) and autologous transplantation (ASCT) resulted in similar progression-free survival (PFS) rates. Sound assessment of overall survival (OS), late complications, incidence of secondary tumors, and cognitive impairment require, however, longer follow-up. Herein, we report the results of this trial at a median follow-up of 88 (IQR 77-99) months. Methods: HIV-negative pts aged 18-70 years with newly diagnosed PCNSL were randomly assigned to receive 4 courses of methotrexate-cytarabine (arm A), or arm A plus rituximab (arm B), or arm B plus thiotepa (MATRix; arm C). A second randomization allocated pts with responsive/stable disease to WBRT (arm D) or carmustine -thiotepa conditioning followed by ASCT (arm E). Treatment effect on cognitive functions and quality of life (QoL) was addressed using the IPCG tests panel and EORTC-QLQ. Results: 219 assessable pts were randomized (arm A 75; B 69; C 75). After induction, 167 had responsive or stable disease; 118 were assigned to WBRT (59) or ASCT (59) while 49 were excluded from second randomization (poor mobilizers, poor conditions, refusal). Fifteen pts died of toxicity during treatment. Of 87 (40%) relapse-free pts (A 17; B 28; C 42), 14 died of infections (4), sudden death (4), cognitive decline (3), second tumor (2) and car accident (1). Among 117 pts with relapse, 96 died of lymphoma, 7 died of salvage therapy complications. Eight pts developed second cancers 48-96 months after WBRT (5) or ASCT (3). Second tumors, deaths in relapse-free pts and deaths during salvage therapy were not significantly related to induction or consolidation treatments. Neuropsychological tests showed a statistically significant impairment in attentiveness and executive functions in pts treated with WBRT, while transplanted pts had a significant improvement in these functions as well as in memory and QoL. Pts treated with MATRix (arm C) showed significantly better PFS (7-year: 52% vs 20% for arm A; vs 29% for arm B) and OS rates (7-year: 56% vs 26% for arm A; vs 37% for arm B). No significant difference was seen between the consolidation arms for either PFS (7-year: 55% for arm D vs 50% for arm E) or OS (7-year: 63% vs 57%). Pts treated with MATRix induction and consolidation had a 7-year OS of 70%, without a significant difference between WBRT and ASCT. IELSG score, number of lesions and induction arm were independent predictors of OS. EA - previously submitted to EHA 2021. The research was funded by: IELSG32 was supported in part by grants from Agenzia Italiana del Farmaco (Ricerca Indipendente FARM99FS3Y), Oncosuisse (KLS 02399-02-2009), Swiss National Science Foundation (31003B_132924) and Cancer Research UK C36711/A12115). Adienne kindly supplied thiotepa for the treatment of patients registered in the UK Keywords: Chemotherapy Combination, Therapies Immunotherapy Conflicts of interests pertinent to the abstract A. J. M. Ferreri Consultant or advisory role: Adienne, Gilead, Novartis, Juno, PLetixaPharm Research funding: BMS, Beigine, Pharmacyclics, Hutchison Medipharma, Amgen, Genmab, ADC Therapeutics, Gilead, Novartis, Pfizer K. Cwynarski Consultant or advisory role: Roche Honoraria: Roche Educational grants: Roche E. Jacobsen Pulczynski Research funding: Roche C. Fox Consultant or advisory role: Abbvie, AstraZeneca, Atarabio, BMS/Celgene, Gilead, Jansen, Incyte, Roche, Takeda Honoraria: Abbvie, Atarabio, BMS/Celgene, Jansen, Incyte, Roche, Takeda Research funding: Abbvie, Gilead, Roche, Takeda Educational grants: Abbvie, BMS/Celgene, Janssen, Roche, Takeda E. Schorb Honoraria: Riemser Pharma GmbH Research funding: Riemser Pharma GmbH K. M. Linton Consultant or advisory role: Genmab - Celgene - Kite/Gilead Honoraria: Janssen Research funding: Roche - Karyopharm Educational grants: Janssen U. Keller Consultant or advisory role: Roche Educational grants: Roche S. Stilgenbauer Consultant or advisory role: AbbVie, Amgen., AstraZeneca, Celgene, Gilead, GSK, Hoffmann-La-Roche, Janssen, Novartis Honoraria: AbbVie, Amgen., AstraZeneca, Celgene, Gilead, GSK, Hoffmann-La-Roche, Janssen, Novartis Research funding: AbbVie, Amgen., AstraZeneca, Celgene, Gilead, GSK, Hoffmann-La-Roche, Janssen, Novartis J. Smith Educational grants: Grant provided to attend 15-ICML by Janssen, but arranged by Janssen (no payment) L. Thurner Consultant or advisory role: Merck, EUSA-Pharma, Takeda Educational grants: EUSA-Pharma, Janssen, Abbvie J. Finke Honoraria: Riemser Research funding: Riemser G. Illerhaus Honoraria: Riemser Educational grants: Riemser" @default.
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• W3174228889 date "2021-06-01" @default.
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• W3174228889 title "MATRIX INDUCTION FOLLOWED BY AUTOLOGOUS STEM CELL TRANSPLANT OR WHOLE‐BRAIN IRRADIATION IN PRIMARY CNS LYMPHOMA. 7‐YEAR RESULTS OF THE IELSG32 RANDOMIZED TRIAL" @default.
• W3174228889 doi "https://doi.org/10.1002/hon.47_2879" @default.
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