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Orelabrutinib-bruton tyrosine kinase inhibitor-based regimens in the treatment of central nervous system lymphoma: a retrospective study

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Summary

Background. Central nervous system lymphoma (CNSL) is an aggressive lymphoma. Orelabrutinib, an oral Bruton tyrosine kinase inhibitor, is a new treatment strategy for CNSL. This study aims to evaluate the efficacy and safety of orelabrutinib-based regimens in the treatment of patients with CNSL. Methods. Twenty-three patients with CNSL were included in this retrospective study. All patients received the orelabrutinib-based regimen. Efficacy was evaluated based on investigators’ assessment of overall response rate (ORR), complete response/unconfirmed complete response (CR/CRu), partial response (PR), stable disease (SD), progressive disease (PD), duration of response (DOR), progression-free survival (PFS) and overall survival (OS). The safety of orelabrutinib-based regimens has also been evaluated. Results. A total of 17.39% of patients received orelabrutinib-based regimens for consolidation therapy, and 82.61% of patients for induction therapy (4 newly diagnosed CNSL, 15 relapsed/refractory CNSL). In the newly diagnosed CNSL group, the ORR was 100% (1 CR, 1 CRu, 2 PR). The 6-month DOR rate, 6-month PFS rate, and 6-month OS rate were 100%, 100%, and 100%, respectively. Of the 15 relapsed/refractory CNSL patients, five therapy regimens were applied (orelabrutinib, n = 3; orelabrutinib/immunotherapy, n = 3; orelabrutinib/chemotherapy, n = 2; orelabrutinib/immunochemotherapy, n = 6; orelabrutinib/radiotherapy, n = 1). The ORR was 60.00% (4 CR, 5 PR). The 6-month DOR rate, 6-month PFS rate, and 6-month OS rate were 92.30%, 67.70%, and 70.00%, respectively. Twenty-one patients reported adverse events (AEs), and 6 patients experienced grade ≥ 3 AEs. Conclusion. Orelabrutinib-based regimens were efficacious and well-tolerated in patients with CNSL. These combined therapies offer a new potential therapeutic strategy for patients with CNSL.

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  1. Jing-Jing Wu and Wen-Hua Wang contributed equally to the manuscript and thus shared the first authorship.

Authors and Affiliations

  1. Department of Oncology, the First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Zhengzhou, Henan, 450052, China

    Jing-Jing Wu, Wen-Hua Wang, Meng Dong, Shan-Shan Ma, Xu-Dong Zhang, Li-Nan Zhu, Song-Tao Niu, Meng-Jie Ding, Jie-Ming Zhang, Lei Zhang, Xin Li, Ling Li, Zhen-Chang Sun, Xin-Hua Wang, Xiao-Rui Fu, Zhao-Ming Li, Yu Chang, Fei-Fei Nan, Jia-Qin Yan, Hui Yu, Xiao-Long Wu, Zhi-Yuan Zhou & Ming-Zhi Zhang

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Contributions

Conception and design, J.W., W.W., M.D., S.M.; Providing materials and samples, J.W., W.W., X.Z., L.Z., S.N., M.D., J.Z.; Data collection, J.W., W.W., L.Z., X.L., L.L., Z. S., X.W.; Data analysis and interpretation, J. W., W. W., X.F., Z. L., Y. C., F. N., J. Y., H.Y., M. Z.; Drafting article, J. W., W. W., X.W., Z.Z.; Administrative support, M. Z.. All the authors have read and approved the final manuscript.

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Correspondence to Ming-Zhi Zhang.

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This study was approved by the ethics committee of the Affiliated Hospital of Zhengzhou University (2021-KY-0886–002).

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Wu, JJ., Wang, WH., Dong, M. et al. Orelabrutinib-bruton tyrosine kinase inhibitor-based regimens in the treatment of central nervous system lymphoma: a retrospective study. Invest New Drugs 40, 650–659 (2022). https://doi.org/10.1007/s10637-022-01219-5

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