Dataset Information

Management and outcome of primary CNS lymphoma in the modern era: An LOC network study.

ABSTRACT:

Objective

Real-life studies on patients with primary CNS lymphoma (PCNSL) are scarce. Our objective was to analyze, in a nationwide population-based study, the current medical practice in the management of PCNSL.

Methods

The French oculo-cerebral lymphoma network (LOC) database prospectively records all newly diagnosed PCNSL cases from 32 French centers. Data of patients diagnosed between 2011 and 2016 were retrospectively analyzed.

Results

We identified 1,002 immunocompetent patients (43% aged >70 years, median Karnofsky Performance Status [KPS] 60). First-line treatment was high-dose methotrexate-based chemotherapy in 92% of cases, with an increasing use of rituximab over time (66%). Patients <60 years of age received consolidation treatment in 77% of cases, consisting of whole-brain radiotherapy (WBRT) (54%) or high-dose chemotherapy with autologous stem cell transplantation (HCT-ASCT) (23%). Among patients >60 years of age, WBRT and HCT-ASCT consolidation were administered in only 9% and 2%, respectively. The complete response rate to initial chemotherapy was 50%. Median progression-free survival was 10.5 months. For relapse, second-line chemotherapy, HCT-ASCT, WBRT, and palliative care were offered to 55%, 17%, 10%, and 18% of patients, respectively. The median, 2-year, and 5-year overall survival was 25.3 months, 51%, and 38%, respectively (<60 years: not reached [NR], 70%, and 61%; >60 years: 15.4 months, 44%, and 28%). Age, KPS, sex, and response to induction CT were independent prognostic factors in multivariate analysis.

Conclusions

Our study confirms the increasing proportion of elderly within the PCNSL population and shows comparable outcome in this population-based study with those reported by clinical trials, reflecting a notable application of recent PCNSL advances in treatment.

SUBMITTER: Houillier C

PROVIDER: S-EPMC7238921 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Management and outcome of primary CNS lymphoma in the modern era: An LOC network study.

Houillier Caroline C Soussain Carole C Ghesquières Hervé H Soubeyran Pierre P Chinot Olivier O Taillandier Luc L Lamy Thierry T Choquet Sylvain S Ahle Guido G Damaj Gandhi G Agapé Philippe P Moluçon-Chabrot Cécile C Amiel Alexandra A Delwail Vincent V Fabbro Michel M Jardin Fabrice F Chauchet Adrien A Moles-Moreau Marie-Pierre MP Morschhauser Franck F Casasnovas Olivier O Gressin Rémy R Fornecker Luc-Matthieu LM Abraham Julie J Marolleau Jean-Pierre JP Tempescul Adrian A Campello Chantal C Colin Philippe P Tamburini Jérôme J Laribi Kamel K Serrier Caroline C Haioun Corinne C Chebrek Safia S Schmitt Anna A Blonski Marie M Houot Roch R Boyle Eileen E Bay Jacques-Olivier JO Oberic Lucie L Tabouret Emeline E Waultier Agathe A Martin-Duverneuil Nadine N Touitou Valérie V Cassoux Nathalie N Kas Aurélie A Mokhtari Karima K Charlotte Frederic F Alentorn Agusti A Feuvret Loïc L Le Garff-Tavernier Magali M Costopoulos Myrto M Mathon Bertrand B Peyre Matthieu M Delgadillo Daniel D Douzane Hassen H Genet Diane D Aidaoui Bachir B Hoang-Xuan Khê K Gyan Emmanuel E

Neurology 20200106 10

<h4>Objective</h4>Real-life studies on patients with primary CNS lymphoma (PCNSL) are scarce. Our objective was to analyze, in a nationwide population-based study, the current medical practice in the management of PCNSL.<h4>Methods</h4>The French oculo-cerebral lymphoma network (LOC) database prospectively records all newly diagnosed PCNSL cases from 32 French centers. Data of patients diagnosed between 2011 and 2016 were retrospectively analyzed.<h4>Results</h4>We identified 1,002 immunocompete ...[more]

PMID: 31907289

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Project description:BackgroundThe purpose of our study was to assess the predictive and prognostic role of 2-18F-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/MRI during high-dose methotrexate-based chemotherapy (HD-MBC) in de novo primary central nervous system lymphoma (PCNSL) patients aged 60 and above.MethodsThis prospective multicentric ancillary study included 65 immunocompetent patients who received induction HD-MBC as part of the BLOCAGE01 phase III trial. FDG-PET/MRI were acquired at baseline, post 2 cycles (PET/MRI2), and posttreatment (PET/MRI3). FDG-PET response was dichotomized with "positive" indicating persistent tumor uptake higher than the contralateral mirroring brain region. Performances of FDG-PET and International PCNSL Collaborative Group criteria in predicting induction response, progression-free survival (PFS), and overall survival (OS) were compared.ResultsOf the 48 PET2 scans performed, 9 were positive and aligned with a partial response (PR) on MRI2. Among these, 8 (89%) progressed by the end of the induction phase. In contrast, 35/39 (90%) of PET2-negative patients achieved complete response (CR). Among the 18 discordant responses at interim (PETCR/MRIPR), 83% ultimately achieved CR. Eighty-seven percent of the PET2-negative patients were disease free at 6 months versus 11% of the PET2-positive patients (P < .001). The MRI2 response did not significantly differentiate patients based on their PFS, regardless of whether they were in CR or PR. Both PET2 and MRI2 independently predicted OS in multivariate analysis, with PET2 showing a stronger association.ConclusionsOur study highlights the potential of interim FDG-PET for early management of PCNSL patients. Response-driven treatment based on PET2 may guide future clinical trials.TrialLOCALYZE, NCT03582254, ancillary of phase III clinical trial BLOCAGE01, NCT02313389 (Registered July 10, 2018-retrospectively registered) https://clinicaltrials.gov/ct2/show/NCT03582254?term=LOCALYZE&draw=2&rank=1.

Dataset Information

Management and outcome of primary CNS lymphoma in the modern era: An LOC network study.

Objective

Methods

Results

Conclusions

Publications

Management and outcome of primary CNS lymphoma in the modern era: An LOC network study.

Similar Datasets

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