Scholarlink

Purpose <p>Given that most PCNSL cases are diagnosed at a late age, they may be unsuitable for consolidation therapy with autologous stem cell transplantation (HDC-ASCT). We thus examine the outcomes of PCNSL in a multiethnic Asian population treated with HD-MTX-based chemotherapy and consolidation WBRT, so as to benchmark current treatment outcomes.</p> Methods <p>We conducted a retrospective study involving patients (<i>n</i> = 129) diagnosed with PCNSL at the National Cancer Centre Singapore from 2000 to 2019. The median follow-up duration was 47.0 months. Survival analyses were performed using the Kaplan-Meier method and Cox proportional models.</p> Results <p>The cohort consisted of 76 male and 53 female patients with a median age of 60 years. 85 patients received HD-MTX-based induction therapy as per DeAngelis, while 44 were treated with the Shah protocol. In univariate analyses, male sex, ECOG scores ≥ 1, non-germinal center subtype, use of DeAngelis protocol, and methotrexate dose &lt; 3&#xa0;g/m<sup>2</sup> were significantly correlated with worse PFS and OS. In a multivariate model, the Shah protocol conferred significantly improved outcomes as compared with the DeAngelis protocol for PFS (HR 0.43, 95% CI 0.25–0.73, <i>p</i> = 0.0019) and OS (HR 0.31, 95% CI 0.16–0.59, <i>p</i> = 0.0004). Using gene expression profiling, poor risk PCNSL patients had a higher trend of CD8 T-cells, macrophages and Th-1 cells, upregulation of <i>TIGIT</i> and <i>HAVCR2</i>, and downregulation in <i>WNT11</i> and <i>CD44</i>.</p> Conclusion <p>Our study demonstrates that contemporary HD-MTX-based chemoimmunotherapy induction regimens achieve good disease responses in PCNSL. We also highlight significant prognostic factors and a potential role for immunotherapy in PCNSL.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Outcomes of primary CNS lymphoma treated with combined immunochemotherapy with whole-brain radiotherapy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月25日

查看全文
  • Ya Hwee Tan,
  • Ryan Mao Heng Lim,
  • Jing Yuan Tan,
  • Boon Yee Lim,
  • Nur Ayuni Binte,
  • Muhammad Taib,
  • Choon Kiat Ong,
  • Chee Leong Cheng,
  • Kheng Wei Yeoh,
  • Soon Thye Lim,
  • Jason Yongsheng Chan

摘要

Purpose

Given that most PCNSL cases are diagnosed at a late age, they may be unsuitable for consolidation therapy with autologous stem cell transplantation (HDC-ASCT). We thus examine the outcomes of PCNSL in a multiethnic Asian population treated with HD-MTX-based chemotherapy and consolidation WBRT, so as to benchmark current treatment outcomes.

Methods

We conducted a retrospective study involving patients (n = 129) diagnosed with PCNSL at the National Cancer Centre Singapore from 2000 to 2019. The median follow-up duration was 47.0 months. Survival analyses were performed using the Kaplan-Meier method and Cox proportional models.

Results

The cohort consisted of 76 male and 53 female patients with a median age of 60 years. 85 patients received HD-MTX-based induction therapy as per DeAngelis, while 44 were treated with the Shah protocol. In univariate analyses, male sex, ECOG scores ≥ 1, non-germinal center subtype, use of DeAngelis protocol, and methotrexate dose < 3 g/m2 were significantly correlated with worse PFS and OS. In a multivariate model, the Shah protocol conferred significantly improved outcomes as compared with the DeAngelis protocol for PFS (HR 0.43, 95% CI 0.25–0.73, p = 0.0019) and OS (HR 0.31, 95% CI 0.16–0.59, p = 0.0004). Using gene expression profiling, poor risk PCNSL patients had a higher trend of CD8 T-cells, macrophages and Th-1 cells, upregulation of TIGIT and HAVCR2, and downregulation in WNT11 and CD44.

Conclusion

Our study demonstrates that contemporary HD-MTX-based chemoimmunotherapy induction regimens achieve good disease responses in PCNSL. We also highlight significant prognostic factors and a potential role for immunotherapy in PCNSL.