Prospective trial on topotecan salvage therapy in primary CNS lymphoma.

Autor: Fischer L; Department of Haematology, Oncology and Transfusion Medicine, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany. lars.fischer@charite.de, Thiel E, Klasen HA, Birkmann J, Jahnke K, Martus P, Korfel A
Jazyk: angličtina
Zdroj: Annals of oncology : official journal of the European Society for Medical Oncology [Ann Oncol] 2006 Jul; Vol. 17 (7), pp. 1141-5. Date of Electronic Publication: 2006 Apr 07.
DOI: 10.1093/annonc/mdl070
Abstrakt: Background: Standard salvage therapy has not been established for recurrent primary central nervous system lymphoma (PCNSL). We report the final results of a prospective study on topotecan chemotherapy in relapsed or refractory PCNSL.
Patients and Methods: The study included 27 patients with a median age of 51 years and an ECOG performance status of 2. Fourteen patients were refractory to the last therapy, and 13 relapsed after a median period of 6.0 months. Pretreatment with up to four regimens included chemotherapy in 26 patients and whole brain irradiation in 14. A 30-min daily topotecan infusion of 1.5 mg/m(2) for 5 days was repeated every 3 weeks.
Results: The response rate was 33% with five complete (CR) and four partial remissions (PR). The median follow-up was 37.7 months. All complete responders had sustained remissions lasting for 9 to 28 months. The median event-free survival (EFS) was 2.0 months (9.1 months in responders), the overall survival (OAS) was 8.4 months. CTC grade 3-4 leukopenia occurred in 26% and thrombocytopenia in 11% of the patients. Eight of 12 patients alive without cerebral lymphoma > or = six months after topotecan exhibited deficits attributable to late neurotoxicity.
Conclusion: Topotecan as monotherapy is active in relapsed and refractory PCNSL with tolerable toxicity.
Databáze: MEDLINE