High-dose methotrexate-based immuno-chemotherapy for elderly primary CNS lymphoma patients (PRIMAIN study)

Fritsch, Kristina and Kasenda, Benjamin and Schorb, Elisabeth and Hau, Peter and Bloehdorn, Johannes and Möhle, R. and Löw, S. and Binder, Mascha and Atta, Johannes and Keller, Ulrich and Wolf, Hans-Heinrich and Krause, Stefan W. and Hess, Georg and Naumann, R. and Sasse, S. and Hirt, Carsten and Lamprecht, M. and Martens, Uwe and Morgner, A. and Panse, J. and Frickhofen, Norbert and Röth, Alexander and Hader, Claudia and Deckert, Martina and Fricker, H. and Ihorst, Gabriele and Finke, Jürgen and Illerhaus, Gerald. (2017) High-dose methotrexate-based immuno-chemotherapy for elderly primary CNS lymphoma patients (PRIMAIN study). Leukemia, 31 (4). pp. 846-852.

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Official URL: https://edoc.unibas.ch/61747/

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To investigate immuno-chemotherapy for elderly immuno-competent patients (⩾65 years) with newly diagnosed primary central nervous system lymphoma, we conducted a multicentre single-arm trial. One cycle consisted of rituximab (375 mg/m(2), days 1, 15, 29), high-dose methotrexate (3 g/m(2) days 2, 16, 30), procarbazine (60 mg/m(2) days 2-11) and lomustine (110 mg/m(2), day 2)-R-MPL protocol. Owing to infectious complications, we omitted lomustine during the study and consecutive patients were treated with the R-MP protocol. Three cycles were scheduled and repeated on day 43. Subsequently, patients commenced 4 weekly maintenance treatment with procarbazine (100 mg for 5 days). Primary end point was complete remission (CR) after 3 cycles. We included 107 patients (69 treated with R-MPL and 38 with R-MP). In all, 38/107 patients achieved CR (35.5%) and 15 (14.0%) achieved partial remission. R-MP was associated with a lower CR rate (31.6%) compared with R-MPL (37.7%), but respective 2-year progression-free survival (All 37.3%; R-MP 34.9%; R-MPL 38.8%) and overall survival (All 47.0%; R-MP 47.7%; R-MPL 46.0%) rates were similar. R-MP was associated with less ⩾grade 3 toxicities compared with R-MPL (71.1% vs 87.0%). R-MP is more feasible while still associated with similar efficacy compared with R-MPL and warrants further improvement in future studies.Leukemia advance online publication, 9 December 2016; doi:10.1038/leu.2016.334.
Faculties and Departments:03 Faculty of Medicine > Departement Klinische Forschung > Clinical Epidemiology and Biostatistics CEB > Klinische Epidemiologie (Bucher H)
UniBasel Contributors:Kasenda, Benjamin
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Springer Nature
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:23 Apr 2020 15:01
Deposited On:23 Apr 2020 15:01

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