Journal of Neuro-Oncology

, Volume 115, Issue 1, pp 71–77

Retrospective study of pemetrexed as salvage therapy for central nervous system lymphoma

  • Jun-Ping Zhang
  • Eudocia Q. Lee
  • Lakshmi Nayak
  • Lisa Doherty
  • Santosh Kesari
  • Alona Muzikansky
  • Andrew D. Norden
  • Huichao Chen
  • Patrick Y. Wen
  • Jan Drappatz
Clinical Study

DOI: 10.1007/s11060-013-1196-1

Cite this article as:
Zhang, JP., Lee, E.Q., Nayak, L. et al. J Neurooncol (2013) 115: 71. doi:10.1007/s11060-013-1196-1

Abstract

There is currently no standard therapy for recurrent or chemotherapy-refractory central nervous system lymphoma (CNSL). Pemetrexed has been reported to have activity in patients with primary CNSL (PCNSL). The use of pemetrexed in secondary CNS lymphoma (SCNSL) has not previously been reported. Here we retrospectively review the outcomes and toxicities of standard and modified doses of pemetrexed as salvage therapy in 18 PCNSL and 12 SCNSL patients. The overall response rate for PCNSL patients was 64.7 %, all of whom achieved a complete response (CR). The median progression-free survival (PFS) was 5.8 months. For the SCNSL patients, RR was 58.3 % with 2 CR (16.7 %); the median PFS was 2.5 months. Grade ≥3 adverse events included leukopenia in 5 patients (16.7 %), neutropenia in 1 patient (3.3 %), and fatigue in 3 patients (10.0 %). 3 patients died while on treatment, 2 due to infections and 1 due to pulmonary embolism. Our results indicate that pemetrexed has activity as salvage therapy in recurrent PCNSL, even with modified dosing, but outcomes trend towards less favorable in SCNSL.

Keywords

Pemetrexed Primary central nervous system lymphoma Secondary central nervous system lymphoma Salvage chemotherapy 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Jun-Ping Zhang
    • 1
  • Eudocia Q. Lee
    • 2
  • Lakshmi Nayak
    • 2
  • Lisa Doherty
    • 2
  • Santosh Kesari
    • 3
  • Alona Muzikansky
    • 4
  • Andrew D. Norden
    • 2
  • Huichao Chen
    • 5
  • Patrick Y. Wen
    • 2
  • Jan Drappatz
    • 6
  1. 1.Department of Neuro-OncologyBeijing Sanbo Brain Hospital, Capital Medical UniversityBeijingChina
  2. 2.Center for Neuro-OncologyDana Farber/Brigham and Women’s Cancer CenterBostonUSA
  3. 3.Department of NeurosciencesCenter for Translational Neuro-Oncology, UC San DiegoLa JollaUSA
  4. 4.Department of BiostatisticsMassachusetts General HospitalBostonUSA
  5. 5.Department of BiostatisticsHarvard School of Public HealthBostanUSA
  6. 6.Division of Hematology and Oncology, Departments of Neurology and MedicineUniversity of Pittsburgh Medical CenterPittsburghUSA

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