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Impact of maintenance rituximab on duration of response in primary central nervous system lymphoma

Journal of Neuro-Oncology volume 147, pages 171–176 (2020)Cite this article

Abstract

Purpose

The role of maintenance immunotherapy with anti-CD20 monoclonal antibody rituximab in primary central nervous system lymphoma (PCNSL) is unclear. We retrospectively reviewed the medical records of all immunocompetent adults with newly diagnosed PCNSL treated at our institution between1996 and 2017.

Methods

We identified 66 patients who attained complete response (CR) after completion of first-line regimen; 20 received maintenance therapy (maintenance therapy group) and 46 were observed with serial MRI scans without maintenance therapy (no-maintenance therapy group).

Results

Compared to the surveillance group, there was a significant increase in duration of survival (HR 0.27, 95% CI 0.08–0.98, P = 0.046) in the maintenance therapy group while the reduction in the risk of progression was not significant (HR: 0.61, 95% CI 0.26–1.43, P = 0.259).

Conclusion

We are evaluating the effectiveness of maintenance immunotherapy in PCNSL in a prospective multicenter randomized clinical trial.

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Acknowledgements

This work was supported in part by National Institute of Health Grants CA137488, NS044687, a Veterans Administration Merit Review Grant and the Walter S. and Lucienne Driskill Foundation, all to EAN.

Funding

The authors have no relevant financial disclosures.

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Authors and Affiliations

  1. Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, L603, Portland, OR, 97239, USA

    Prakash Ambady, Laszlo Szidonya, Nancy D. Doolittle & Edward A. Neuwelt

  2. School of Public Health, Department of Clinical Epidemiology and Medical Informatics, Oregon Health & Science University, Portland, OR, USA

    Rongwei Fu

  3. Burkhardt Brain Tumor Center, Cleveland Clinic, Cleveland, OH, USA

    David M. Peereboom

  4. Department of Neurosurgery, Oregon Health & Science University, Portland, OR, USA

    Edward A. Neuwelt

  5. Portland Veterans Affairs Medical Center, Portland, OR, USA

    Edward A. Neuwelt

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  1. Prakash Ambady
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  2. Rongwei Fu
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  3. Laszlo Szidonya
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  4. David M. Peereboom
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  5. Nancy D. Doolittle
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  6. Edward A. Neuwelt
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Correspondence to Edward A. Neuwelt.

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Ambady, P., Fu, R., Szidonya, L. et al. Impact of maintenance rituximab on duration of response in primary central nervous system lymphoma. J Neurooncol 147, 171–176 (2020). https://doi.org/10.1007/s11060-020-03411-0

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  • DOI: https://doi.org/10.1007/s11060-020-03411-0

Keywords

  • Primary CNS lymphoma
  • Maintenance therapy
  • Rituximab
  • High-dose methotrexate