The study covered in this summary was published on researchsquare.com as a preprint and has not yet been peer reviewed.
Key Takeaway
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High-dose cytarabine plus temozolomide is well tolerated in patients with refractory or recurrent primary central nervous system (CNS) lymphoma and may have promise for patients with KIR-HLA genotypes.
Why This Matters
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An effective salvage regimen for the reinduction of remission in refractory or recurrent primary CNS lymphoma is lacking.
Study Design
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The team reviewed 30 patients with refractory or recurrent primary CNS lymphoma treated with two doses of cytarabine 3 g/m2 over 2 days combined with temozolomide 150 mg/m2 for 5 days.
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KIR and HLA genotyping was performed on peripheral blood samples from each patient.
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Patients were a median age of 65 years.
Key Results
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The overall response rate was 43.4% (13/30 patients) over a median follow-up of 16 months, which aligns with a previous report evaluating four doses of cytarabine, but with less toxicity.
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Median progression-free survival (PFS) was 1.75 months and median overall survival 19.5 months.
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Treatment toxicity was mild and manageable.
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Patients harboring KIR3DL1/HLA-B genotypes predicting low affinity had a higher response rate and longer median PFS of 3 months, vs those with KIR3DL1/HLA-B genotypes predicted high affinity (with a median PFS of 1 month).
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KIR/HLA-B genotypes were independently associated with PFS but had no impact on overall survival.
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To compare, a previous report in a small cohort found temozolomide combined with ibrutinib achieved an overall response rate of 55% and a median PFS of 5.3 months for refractory or recurrent primary CNS lymphoma.
Limitations
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It was a small, retrospective study at a single institution.
Disclosures
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The Shanghai Shenkang Clinical Innovation Project funded the study.
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The investigators reported no financial conflicts.
This is a summary of a preprint research study, “Specific KIR-HLA genotypes predict the outcomes of refractory or recurrent primary central nervous system lymphoma,” led by Zhiguang Lin of Fudan University, Shanghai, China, provided to you by Medscape. The study has not been peer reviewed. The full text can be found at researchsquare.com.
M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: [email protected].
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