Primary central nervous system lymphomas

Salvage treatment after failure to high-dose methotrexate

Michele Reni, Elena Mazza, Marco Foppoli, Andrés J M Ferreri

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

This review analyzes the major methodological caveats related to the design and conduction of trials addressing new active drugs in patients with failed primary CNS lymphoma (PCNSL) and provides some recommendations for their therapeutic management. The enrolment of patients in well-designed prospective trials is the best option at failure. In the clinical practice, radiotherapy is an option for unirradiated patients and re-treatment with high-dose methotrexate (HD-MTX) can be suggested to relapsing patients who experienced a prolonged lymphoma remission after first-line chemotherapy containing HD-MTX. Salvage monochemotherapy with temozolomide or topotecan in patients previously managed with a radiotherapy-containing approach is supported by prospective trials, while the combination chemotherapy remains investigational. High-dose chemotherapy supported by stem cell autotransplant and intrathecal chemotherapy in meningeal failure have to be further investigated in prospective trials.

Original languageEnglish
Pages (from-to)165-170
Number of pages6
JournalCancer Letters
Volume258
Issue number2
DOIs
Publication statusPublished - Dec 18 2007

Fingerprint

Salvage Therapy
Treatment Failure
Methotrexate
Lymphoma
Central Nervous System
temozolomide
Drug Therapy
Radiotherapy
Topotecan
Autografts
Combination Drug Therapy
Stem Cells
Therapeutics
Pharmaceutical Preparations

Keywords

  • High-dose methotrexate
  • Primary central nervous system lymphomas
  • Salvage treatment
  • Temozolomide

ASJC Scopus subject areas

  • Cancer Research
  • Molecular Biology
  • Oncology

Cite this

Primary central nervous system lymphomas : Salvage treatment after failure to high-dose methotrexate. / Reni, Michele; Mazza, Elena; Foppoli, Marco; Ferreri, Andrés J M.

In: Cancer Letters, Vol. 258, No. 2, 18.12.2007, p. 165-170.

Research output: Contribution to journalArticle

@article{291c69cb16f24a15ac2f39d8008a0dbb,
title = "Primary central nervous system lymphomas: Salvage treatment after failure to high-dose methotrexate",
abstract = "This review analyzes the major methodological caveats related to the design and conduction of trials addressing new active drugs in patients with failed primary CNS lymphoma (PCNSL) and provides some recommendations for their therapeutic management. The enrolment of patients in well-designed prospective trials is the best option at failure. In the clinical practice, radiotherapy is an option for unirradiated patients and re-treatment with high-dose methotrexate (HD-MTX) can be suggested to relapsing patients who experienced a prolonged lymphoma remission after first-line chemotherapy containing HD-MTX. Salvage monochemotherapy with temozolomide or topotecan in patients previously managed with a radiotherapy-containing approach is supported by prospective trials, while the combination chemotherapy remains investigational. High-dose chemotherapy supported by stem cell autotransplant and intrathecal chemotherapy in meningeal failure have to be further investigated in prospective trials.",
keywords = "High-dose methotrexate, Primary central nervous system lymphomas, Salvage treatment, Temozolomide",
author = "Michele Reni and Elena Mazza and Marco Foppoli and Ferreri, {Andr{\'e}s J M}",
year = "2007",
month = "12",
day = "18",
doi = "10.1016/j.canlet.2007.10.009",
language = "English",
volume = "258",
pages = "165--170",
journal = "Cancer Letters",
issn = "0304-3835",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

TY - JOUR

T1 - Primary central nervous system lymphomas

T2 - Salvage treatment after failure to high-dose methotrexate

AU - Reni, Michele

AU - Mazza, Elena

AU - Foppoli, Marco

AU - Ferreri, Andrés J M

PY - 2007/12/18

Y1 - 2007/12/18

N2 - This review analyzes the major methodological caveats related to the design and conduction of trials addressing new active drugs in patients with failed primary CNS lymphoma (PCNSL) and provides some recommendations for their therapeutic management. The enrolment of patients in well-designed prospective trials is the best option at failure. In the clinical practice, radiotherapy is an option for unirradiated patients and re-treatment with high-dose methotrexate (HD-MTX) can be suggested to relapsing patients who experienced a prolonged lymphoma remission after first-line chemotherapy containing HD-MTX. Salvage monochemotherapy with temozolomide or topotecan in patients previously managed with a radiotherapy-containing approach is supported by prospective trials, while the combination chemotherapy remains investigational. High-dose chemotherapy supported by stem cell autotransplant and intrathecal chemotherapy in meningeal failure have to be further investigated in prospective trials.

AB - This review analyzes the major methodological caveats related to the design and conduction of trials addressing new active drugs in patients with failed primary CNS lymphoma (PCNSL) and provides some recommendations for their therapeutic management. The enrolment of patients in well-designed prospective trials is the best option at failure. In the clinical practice, radiotherapy is an option for unirradiated patients and re-treatment with high-dose methotrexate (HD-MTX) can be suggested to relapsing patients who experienced a prolonged lymphoma remission after first-line chemotherapy containing HD-MTX. Salvage monochemotherapy with temozolomide or topotecan in patients previously managed with a radiotherapy-containing approach is supported by prospective trials, while the combination chemotherapy remains investigational. High-dose chemotherapy supported by stem cell autotransplant and intrathecal chemotherapy in meningeal failure have to be further investigated in prospective trials.

KW - High-dose methotrexate

KW - Primary central nervous system lymphomas

KW - Salvage treatment

KW - Temozolomide

UR - http://www.scopus.com/inward/record.url?scp=36048963863&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36048963863&partnerID=8YFLogxK

U2 - 10.1016/j.canlet.2007.10.009

DO - 10.1016/j.canlet.2007.10.009

M3 - Article

VL - 258

SP - 165

EP - 170

JO - Cancer Letters

JF - Cancer Letters

SN - 0304-3835

IS - 2

ER -