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维持性利妥昔单抗治疗对原发性中枢神经系统淋巴瘤缓解持续时间的影响。

Impact of maintenance rituximab on duration of response in primary central nervous system lymphoma.

机构信息

Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, L603, Portland, OR, 97239, USA.

School of Public Health, Department of Clinical Epidemiology and Medical Informatics, Oregon Health & Science University, Portland, OR, USA.

出版信息

J Neurooncol. 2020 Mar;147(1):171-176. doi: 10.1007/s11060-020-03411-0. Epub 2020 Feb 5.

DOI:10.1007/s11060-020-03411-0
PMID:32026432
Abstract

PURPOSE

The role of maintenance immunotherapy with anti-CD20 monoclonal antibody rituximab in primary central nervous system lymphoma (PCNSL) is unclear. We retrospectively reviewed the medical records of all immunocompetent adults with newly diagnosed PCNSL treated at our institution between1996 and 2017.

METHODS

We identified 66 patients who attained complete response (CR) after completion of first-line regimen; 20 received maintenance therapy (maintenance therapy group) and 46 were observed with serial MRI scans without maintenance therapy (no-maintenance therapy group).

RESULTS

Compared to the surveillance group, there was a significant increase in duration of survival (HR 0.27, 95% CI 0.08-0.98, P = 0.046) in the maintenance therapy group while the reduction in the risk of progression was not significant (HR: 0.61, 95% CI 0.26-1.43, P = 0.259).

CONCLUSION

We are evaluating the effectiveness of maintenance immunotherapy in PCNSL in a prospective multicenter randomized clinical trial.

摘要

目的

抗 CD20 单克隆抗体利妥昔单抗维持免疫治疗在原发性中枢神经系统淋巴瘤(PCNSL)中的作用尚不清楚。我们回顾性分析了 1996 年至 2017 年间在我院接受治疗的所有免疫功能正常的新诊断为 PCNSL 的成年患者的病历。

方法

我们确定了 66 例在完成一线方案后达到完全缓解(CR)的患者;其中 20 例接受维持治疗(维持治疗组),46 例未接受维持治疗(无维持治疗组),仅进行了系列 MRI 扫描。

结果

与观察组相比,维持治疗组的生存时间显著延长(HR 0.27,95%CI 0.08-0.98,P=0.046),而进展风险降低不显著(HR:0.61,95%CI 0.26-1.43,P=0.259)。

结论

我们正在前瞻性多中心随机临床试验中评估 PCNSL 维持免疫治疗的有效性。

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Patterns of relapse in primary central nervous system lymphoma: inferences regarding the role of the neuro-vascular unit and monoclonal antibodies in treating occult CNS disease.原发性中枢神经系统淋巴瘤的复发模式:关于神经血管单元和单克隆抗体在治疗隐匿性中枢神经系统疾病中的作用的推断。
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Patterns of relapse after successful completion of initial therapy in primary central nervous system lymphoma: a case series.原发性中枢神经系统淋巴瘤初始治疗成功后复发模式:病例系列研究。
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甲氨蝶呤、阿糖胞苷、噻替派和利妥昔单抗联合化疗免疫疗法(MATRix方案)用于原发性中枢神经系统淋巴瘤患者:国际结外淋巴瘤研究组-32(IELSG32)2期试验首次随机分组结果
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