Table 1.
Selected trials on mono-chemotherapy for relapsed/refractory PCNSL.
| Study | Study design | Sample | Median age (years) | Mono-chemotherapy | Mechanism of chemotherapeutic | Administration | ORR (CR, PR) (%) | mPFS/mOS (months) | Grade 3/4/5 toxicity | |
|---|---|---|---|---|---|---|---|---|---|---|
| Traditional Chemotherapeutics | Fischer et al. (91) | prospective | 27 | 51 | Topotecan | Topoisomerase I inhibitors | 1.5mg/m2/d × 5days, every 3 weeks | 33 (18, 15) | EFS 2.0/8.4 | Leukopenia (26%) Neutropenia (11%) Thrombocytopenia (11%) Infection (11%) Anemia (3.7%) Non-hematologic toxicity (7%) |
| Voloschin et al. (92) | prospective | 15 | 56 | Topotecan | Topoisomerase I inhibitors | 1.5mg/m2/d × 5 days, every 3 weeks | 40 (20, 20) | 2/981days | Neutropenia (73%) Thrombocytopenia (20%) |
|
| Raizer et al. (93) | NA | 11 | 69.8 | Pemetrexed | Multitarget antifolate | 900 mg/m2/d, every 3 weeks | 55 (36.3, 18.2) | 5.7/10.1 | Thrombocytopenia (45%) Leukopenia (36%) Anemia (27%) Infection (36%) Abnormal liver function (9%) |
|
| Makino et al. (94) | retrospective | 17 | 68 | Temozolomide | Alkylating | 150–200 mg/m2 × 5 days, every 4 weeks | 47 (29, 18) | 1.9/6.7 | Neutropenia (6%) Thrombocytopenia (6%) |
|
| Chamberlain et al. (95) | retrospective | 12 | 61.5 | Bendamustine | Bifunctional alkylating | 100 mg/m2/d × 2 days, every 4 weeks | 50 (25, 25) | 3.5/5.5 | Lymphopenia (33%) Anemia (17%), nausea (17%) Fatigue (8%), hyperglycemia (8%) Neutrophil reduction (8%) |
|
| Targeted Therapy | Batchelor et al. (96) | prospective | 12 | 64 | Rituximab | Anti-CD20 monoclonal antibody | 375 mg/m2/W × 8 weeks | 36 (27, 9) | 57 days/20.9 | Allergic reaction, fatigue Anxiety, back pain (6%) |
| Houillier et al. (97) | retrospective | 6 | 73.5 | Lenalidomide | Immunomodulator | 25 mg/d × 21 days, every 4weeks | 50 (33, 17) | NA/4 | None | |
| Korfel et al. (5) | prospective | 37 | 70 | Temsirolimus | mTOR inhibitor | 25 or 75mg/w | 54 (13.5, 32.4, CRu 8) | 2.1/NA | Hyperglycemia (29.7%) Thrombocytopenia (21.6%) Infection (19%) Anemia (10.8%) Rash (8.1%) |
|
| Chamoun et al. (98) | retrospective | 14 | 68 | Ibrutinib | BTK inhibitor | 560mg/d | 50 (42.8, 57.2) | 6/NA | neutropenic fever (7%) diarrhea (7%) peritumoral hemorrhage (7%) |
|
| Grommes et al. (99) | prospective | 13 | 69 | Ibrutinib | BTK inhibitor | 560mg/d or 840mg/d | 77 (38.5, 38.5) | 4.6/15 | Lymphopenia (20%) Neutropenia (15%) Hyperglycemia (15%) Thrombocytopenia (10%) Leukopenia (10%) Pulmonary infection (10%) Anemia (5%) Hypertriglyceridemia (5%) |
|
| Soussain et al. (100) | prospective | 52 | 67.5 | Ibrutinib | BTK inhibitor | 560mg/d | DC=62 (19, 33) | 4.8/19.2 | Infections and infestations (4%) Cardiac disorders (2%) General disorders and administration site conditions (2%) Blood and lymphatic system disorders (8%) Eye disorders (2%) Investigations (8%) |
|
| Nayak et al. (101) | NA | 4 relapsed/refractory PCNSL 1 CNS relapsed PTL |
64 | Nivolumab | Anti-PD1 monoclonal antibody | 3 mg/kg, every 2 weeks | 100 (80, 20) | 14+/NA | None |
PTL, primary testicular lymphoma; NA, not available; DC, disease control.