MATILDE chemotherapy regimen for primary CNS lymphoma: Results at a median follow-up of 12 years

Andrés J M Ferreri, Fabio Ciceri, Alba A. Brandes, Mauro Montanari, Monica Balzarotti, Michele Spina, Fiorella Ilariucci, Francesco Zaja, Caterina Stelitano, Flavio Bobbio, Gaetano Corazzelli, Luca Baldini, Michele Reni

Research output: Contribution to journalArticle

Abstract

Objective: We report updated results at a median follow-up of 12 years of a phase II trial assessing first-line MATILDE chemotherapy and response-tailored radiotherapy in patients with primary CNS lymphomas (PCNSL). Methods: Forty-one HIV-negative patients (18-70 years; Eastern Cooperative Oncology Group performance status ≤3) with histologically confirmed PCNSL received 3 courses of MATILDE chemotherapy followed by whole-brain radiotherapy (WBRT). Chemotherapy activity was the primary endpoint. Results: Overall response rate was 76% (95% confidence interval [CI] 63%-89%) after chemotherapy and 83% (95% CI 71%-95%) after chemotherapy ± radiotherapy. At a median follow-up of 144 months (range 47-153), 31 patients experienced an event: relapse in 24, progressive disease in 3, and toxic death in 4, with a 5-year progression-free survival of 24% ± 8%. Two patients experienced a late relapse (100 and 101 months). Nine patients are alive and disease-free, 8 of whom are alive at >10 years, with a 5-year overall survival of 30% ± 7%. At 10 years from diagnosis, no patient showed chronic hematologic and nonhematologic toxicities, with a Mini-Mental State Examination score of ≥29 in all cases but one. Conclusions: At a median follow-up of 12 years, MATILDE regimen followed by WBRT confirmed the previously reported survival plateau, which further proves its long-lasting efficacy with acceptable neurologic deficits. Classification of evidence: This study provides Class IV evidence that in patients with PCNSL, MATILDE chemotherapy followed by response-tailored radiotherapy increases the probability of disease remission at 12 years.

Original languageEnglish
Pages (from-to)1370-1373
Number of pages4
JournalNeurology
Volume82
Issue number15
DOIs
Publication statusPublished - Apr 15 2014

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Lymphoma
Drug Therapy
Radiotherapy
Confidence Intervals
Recurrence
Survival
Poisons
Brain
Neurologic Manifestations
MATILDE regimen
Chemotherapy
Central Nervous System
Disease-Free Survival
HIV

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

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MATILDE chemotherapy regimen for primary CNS lymphoma : Results at a median follow-up of 12 years. / Ferreri, Andrés J M; Ciceri, Fabio; Brandes, Alba A.; Montanari, Mauro; Balzarotti, Monica; Spina, Michele; Ilariucci, Fiorella; Zaja, Francesco; Stelitano, Caterina; Bobbio, Flavio; Corazzelli, Gaetano; Baldini, Luca; Reni, Michele.

In: Neurology, Vol. 82, No. 15, 15.04.2014, p. 1370-1373.

Research output: Contribution to journalArticle

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abstract = "Objective: We report updated results at a median follow-up of 12 years of a phase II trial assessing first-line MATILDE chemotherapy and response-tailored radiotherapy in patients with primary CNS lymphomas (PCNSL). Methods: Forty-one HIV-negative patients (18-70 years; Eastern Cooperative Oncology Group performance status ≤3) with histologically confirmed PCNSL received 3 courses of MATILDE chemotherapy followed by whole-brain radiotherapy (WBRT). Chemotherapy activity was the primary endpoint. Results: Overall response rate was 76{\%} (95{\%} confidence interval [CI] 63{\%}-89{\%}) after chemotherapy and 83{\%} (95{\%} CI 71{\%}-95{\%}) after chemotherapy ± radiotherapy. At a median follow-up of 144 months (range 47-153), 31 patients experienced an event: relapse in 24, progressive disease in 3, and toxic death in 4, with a 5-year progression-free survival of 24{\%} ± 8{\%}. Two patients experienced a late relapse (100 and 101 months). Nine patients are alive and disease-free, 8 of whom are alive at >10 years, with a 5-year overall survival of 30{\%} ± 7{\%}. At 10 years from diagnosis, no patient showed chronic hematologic and nonhematologic toxicities, with a Mini-Mental State Examination score of ≥29 in all cases but one. Conclusions: At a median follow-up of 12 years, MATILDE regimen followed by WBRT confirmed the previously reported survival plateau, which further proves its long-lasting efficacy with acceptable neurologic deficits. Classification of evidence: This study provides Class IV evidence that in patients with PCNSL, MATILDE chemotherapy followed by response-tailored radiotherapy increases the probability of disease remission at 12 years.",
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T2 - Results at a median follow-up of 12 years

AU - Ferreri, Andrés J M

AU - Ciceri, Fabio

AU - Brandes, Alba A.

AU - Montanari, Mauro

AU - Balzarotti, Monica

AU - Spina, Michele

AU - Ilariucci, Fiorella

AU - Zaja, Francesco

AU - Stelitano, Caterina

AU - Bobbio, Flavio

AU - Corazzelli, Gaetano

AU - Baldini, Luca

AU - Reni, Michele

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N2 - Objective: We report updated results at a median follow-up of 12 years of a phase II trial assessing first-line MATILDE chemotherapy and response-tailored radiotherapy in patients with primary CNS lymphomas (PCNSL). Methods: Forty-one HIV-negative patients (18-70 years; Eastern Cooperative Oncology Group performance status ≤3) with histologically confirmed PCNSL received 3 courses of MATILDE chemotherapy followed by whole-brain radiotherapy (WBRT). Chemotherapy activity was the primary endpoint. Results: Overall response rate was 76% (95% confidence interval [CI] 63%-89%) after chemotherapy and 83% (95% CI 71%-95%) after chemotherapy ± radiotherapy. At a median follow-up of 144 months (range 47-153), 31 patients experienced an event: relapse in 24, progressive disease in 3, and toxic death in 4, with a 5-year progression-free survival of 24% ± 8%. Two patients experienced a late relapse (100 and 101 months). Nine patients are alive and disease-free, 8 of whom are alive at >10 years, with a 5-year overall survival of 30% ± 7%. At 10 years from diagnosis, no patient showed chronic hematologic and nonhematologic toxicities, with a Mini-Mental State Examination score of ≥29 in all cases but one. Conclusions: At a median follow-up of 12 years, MATILDE regimen followed by WBRT confirmed the previously reported survival plateau, which further proves its long-lasting efficacy with acceptable neurologic deficits. Classification of evidence: This study provides Class IV evidence that in patients with PCNSL, MATILDE chemotherapy followed by response-tailored radiotherapy increases the probability of disease remission at 12 years.

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