| Title: |
Survival, neurocognitive function, and health-related quality of life outcomes after rituximab-methotrexate, BCNU, teniposide, and prednisolone for primary CNS lymphoma:Final Results of the HOVON 105 / ALLG NHL 24 Study |
| Authors: |
Bromberg,Jacoline E C; Issa,Samar; van der Holt,Bronno; van der Meulen,Matthijs; Dirven,Linda; Minnema, Monique C; Seute, Tatjana; Durian,Marc; Cull,Gavin; van der Poel,Marjolein W M; Stevens,Wendy B C; Zijlstra,Josee M; Brandsma,Dieta; Nijland,Marcel; Mason,Kylie D; Beeker,Aart; Abrahamse-Testroote,Martine C J; van den Bent,Martin J; de Jong,Daphne; Doorduijn,Jeanette K; MS Hematologie; Cancer; Infection & Immunity; Regenerative Medicine and Stem Cells; Neurologen |
| Publication Year: |
2024 |
| Subject Terms: |
PCNSL; health-related quality of life; neurocognitive function; rituximab; treatment; Clinical Neurology; Oncology; Cancer Research |
| Description: |
BACKGROUND: Studies on the efficacy of rituximab in primary CNS lymphoma (PCNSL) reported conflicting results. Our international randomized phase 3 study showed that the addition of rituximab to high-dose methotrexate, BCNU, teniposide, and prednisolone (MBVP) in PCNSL was not efficacious in the short term. Here we present long-term results after a median follow-up of 82.3 months. METHODS: One hundred and ninety-nine eligible newly diagnosed, nonimmunocompromised patients with PCNSL aged 18-70 years with WHO performance status 0-3 was randomized between treatment with MBVP chemotherapy with or without rituximab, followed by high-dose cytarabine consolidation in responding patients, and reduced-dose WBRT in patients aged ≤ 60 years. Event-free survival was the primary endpoint. Overall survival rate, neurocognitive functioning (NCF), and health-related quality of life (HRQoL) were additionally assessed, with the IPCG test battery, EORTC QLQ-C30 and QLQ-BN20 questionnaires, respectively. RESULTS: For event-free survival, the hazard ratio was 0.85, 95% CI 0.61-1.18, P = .33. Overall survival rate at 5 years for MBVP and R-MBVP was 49% (39-59) and 53% (43-63) respectively. In total, 64 patients died in the MBVP arm and 55 in the R-MBVP arm, of which 69% were due to PCNSL. At the group level, all domains of NCF and HRQoL improved to a clinically relevant extent after treatment initiation, and remained stable thereafter up to 60 months of follow-up, except for motor speed which deteriorated between 24 and 60 months. Although fatigue improved initially, high levels persisted in the long term. CONCLUSIONS: Long-term follow-up confirms the lack of added value of rituximab in addition to MBVP and HD-cytarabine for PCNSL. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text/plain |
| Language: |
English |
| ISSN: |
1522-8517 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/450648 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/450648 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.9F93D296 |
| Database: |
BASE |