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利妥昔单抗-来那度胺-伊布替尼联合方案治疗复发/难治性原发性中枢神经系统淋巴瘤:LOC 网络病例系列

英文原题:Rituximab-Lenalidomide-Ibrutinib Combination for Relapsed/Refractory Primary CNS Lymphoma: A Case Series of the LOC Network.

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Rituximab-Lenalidomide-Ibrutinib Combination for Relapsed/Refractory Primary CNS Lymphoma: A Case Series of the LOC Network.

PubMed 2021/09/28(内容时间) Neurology Q1 · IF 8.9(JCR 2025)

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

研究概要

R 2 I 联合方案在预后不良、既往接受大量治疗的患者中产生了高比例的快速起效缓解,毒性可控,并使 3 例患者得以进入巩固治疗。

中文摘要

评估利妥昔单抗-来那度胺-伊布替尼(R²I)联合方案治疗复发/难治性(R/R)原发性中枢神经系统淋巴瘤(PCNSL)的疗效和耐受性。

从法国LOC数据库中回顾性筛选并分析接受R²I治疗的R/R PCNSL患者。

共14例患者接受R²I治疗,中位年龄63岁,Karnofsky体能状态评分中位数为75%;治疗前既往化疗中位数为2线,其中5例曾接受自体干细胞移植(ASCT)。最佳疗效为完全缓解4/14例、部分缓解4/14例,中位起效时间为2.5个月。3名应答患者在R²I治疗后接受巩固治疗(全脑放疗2例,ASCT 1例);另有1例将R²I作为CAR-T 治疗前的桥接方案。3/14例患者因毒性停用R²I,未发生毒性相关死亡。讨论:对于既往接受多线治疗、预后较差的患者,R²I联合方案可快速诱导较高缓解率,毒性可控,并使3名患者得以继续接受巩固治疗。尽管结果仍属初步,但支持在常规化疗失败的R/R PCNSL患者中使用R²I。证据等级:本研究提供Ⅳ级证据,表明利妥昔单抗、来那度胺和伊布替尼联合可使既往多线治疗的R/R PCNSL患者获得较高缓解率。

展开英文摘要原文

R/R PCNSL patients treated with R 2 I were retrospectively selected and analyzed from the French LOC database.

Fourteen patients (median age: 63 years, median Karnofsky Performance Status: 75%) received R 2 I, administered after a median of 2 previous lines of chemotherapy, including autologous stem cell transplantation (ASCT) in 5 cases. The best response was complete response in 4/14 patients and partial response in 4/14 patients, achieved in a median of 2.5 months. Three responder patients received consolidation treatment (WBRT: N = 2, ASCT: N = 1) after R 2 I, and R 2 I served as a bridge before CAR-T cell therapy for one patient. R 2 I was discontinued due to toxicity in 3/14 patients. There were no toxicity-related deaths. DISCUSSION: The R 2 I combination resulted in a high rate of response of rapid-onset in heavily pretreated patients with poor prognosis, with manageable toxicity, and allowed 3 patients to proceed to consolidation. Although preliminary, these results support the use of R 2 I for R/R PCNSL failing conventional chemotherapies. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that combination of rituximab-lenalidomide-ibrutinib induces a high rate of response in heavily pretreated R/R PCNSL.

论文信息

作者
Houillier C、Chabrot CM、Moles-Moreau MP、Willems L、Ahle G、Waultier-Rascalou A、Fornecker LM、Hoang-Xuan K
单位
From the APHP (C.H., K.H.-X.), Sorbonne Université, IHU, ICM, Service de Neurologie 2-Mazarin, Groupe Hospitalier Pitié-Salpêtrière, Paris; Service d'Hématologie (C.M.C.), CHU de Clermont-Ferrand, Clermont-Ferrand; Service des Maladies du Sang (M.-P.M.-M.), CHU d'Angers; APHP (L.W.), Hôpital Cochin, Service d'Hématologie, Paris; Service de Neurologie (G.A.), Hôpitaux Civils, Colmar; Service d'Hématologie (A.W.-R.), CHU de Nîmes; Service d'Hématologie (L.-M.F.), Institut de Cancérologie de Strasbourg Europe, Strasbourg; Service d'Hématologie (C.S.), Institut Curie, Site Saint Cloud; INSERM U932 (C.S.), Institut Curie, PSL Research University, Paris. caroline.houillier@aphp.fr.France
期刊
Neurology2021 Sep 28
原文标识
PubMed 34580183 · DOI 10.1212/WNL.0000000000012515