背景:巩固治疗可改善原发性中枢神经系统淋巴瘤(PCNSL)患者的反应持续时间。来那度胺维持治疗在老年PCNSL患者中显示出令人鼓舞的结果。在这里,我们做了一个回顾,单中心分析评估来那度胺维持治疗对新诊断PCNSL患者缓解持续时间的影响。
方法:纳入69名在诱导治疗后达到完全缓解或部分缓解(PR)的PCNSL成年患者。患者的中位年龄为58.0岁。维持组(n=35)口服来那度胺(25mg/天),持续21天,每28天一次,共24个月;观察组未接受任何进一步治疗。
结果:中位随访32.6个月后,维持组复发事件较少.然而,组间中位无进展生存期(PFS)相似(36.1vs.30.6个月;危险比,0.78;95%置信区间,0.446)。来那度胺维持治疗仅在诱导后经历PR的患者中显着改善了PFS和总体生存率(OS)。来那度胺维持的中位持续时间为18个月;来那度胺耐受性良好,对生活质量的影响最小。
结论:本研究首次评估来那度胺维持作为PCNSL患者的一线治疗,PFS和OS没有改善,尽管安全性令人满意。
BACKGROUND: Consolidation therapy improves the duration of response among patients with primary central nervous system lymphoma (PCNSL). Lenalidomide maintenance has shown encouraging results in older patients with PCNSL. Herein, we performed a retrospective, single-center analysis to evaluate the effect of lenalidomide maintenance on the duration of response in patients with newly-diagnosed PCNSL.
METHODS: Sixty-nine adult patients with PCNSL who achieved complete remission or partial remission (PR) after induction therapy were enrolled. The median age of patients was 58.0 years. The maintenance group (n = 35) received oral lenalidomide (25 mg/day) for 21 days, every 28 days for 24 months; the observation group did not undergo any further treatment.
RESULTS: After a median follow-up of 32.6 months, the maintenance group experienced fewer relapse events. However, the median progression-free survival (PFS) was similar between groups (36.1 vs. 30.6 months; hazard ratio, 0.78; 95% confidence interval, 0.446). Lenalidomide maintenance significantly improved PFS and overall survival (OS) only among patients who experienced PR after induction. The median duration of lenalidomide maintenance was 18 months; lenalidomide was well tolerated and minimally impacted the quality of life.
CONCLUSIONS: The present study was the first to evaluate lenalidomide maintenance as a frontline treatment among patients with PCNSL, PFS and OS did not improve, although the safety profile was satisfactory.