Increasing use of immunotherapy and prolonged survival among younger patients with primary CNS lymphoma: a population-based study.

Abstract

Background: Primary CNS lymphoma is a highly aggressive and rare type of extranodal non-Hodgkin lymphoma. Although, new therapeutic approaches have led to improved survival, the management of the disease poses a challenge, practice patterns vary across institutions and countries, and remain ill-defined for vulnerable patient subgroups. Material and Methods: Using information from the Austrian Brain Tumor Registry we followed a population-based cohort of 189 patients newly diagnosed from 2005 to 2010 through various lines of treatment until death or last follow-up (12-31-2016). Prognostic factors and treatment-related data were integrated in a comprehensive survival analysis including conditional survival estimates. Results: We find variable patterns of first-line treatment with increasing use of rituximab and high-dose methotrexate (HDMTX)-based poly-chemotherapy after 2007, paralleled by an increase in median overall survival restricted to patients aged below 70 years. In the entire cohort, 5-year overall survival was 24.4% while 5-year conditional survival increased with every year postdiagnosis. Conclusion: In conclusion, we show that the use of poly-chemotherapy and immunotherapy has disseminated to community practice to a fair extent and survival has increased over time at least in younger patients. Annually increasing conditional survival rates provide clinicians with an adequate and encouraging prognostic measure.

• Authors: Magdalena Neuhauser, Thomas Roetzer, Stefan Oberndorfer, Melitta Kitzwoegerer, Franz Payer, Julia J Unterluggauer, Johannes Haybaeck, Günther Stockhammer, Sarah Iglseder, Patrizia Moser, Claudius Thomé, Martin Stultschnig, Franz Wuertz, Tanisa Brandner-Kokalj, Serge Weis, Dave Bandke, Josef Pichler, Markus Hutterer, Karl J Krenosz, Alexandra Boehm, Beate Mayrbaeurl, Andrea Hager-Seifert, Hannes Kaufmann, Martina Dumser, Angelika Reiner-Concin, Selma Hoenigschnabl, Waltraud Kleindienst, Markus Hoffermann, Karin Dieckmann, Barbara Kiesel, Georg Widhalm, Christine Marosi, Ulrich Jaeger, Andreas Hainfellner, Monika Hackl, Johannes A Hainfellner, Matthias Preusser, Adelheid Woehrer
• Journal: Acta oncologica (Stockholm, Sweden) (Acta Oncol) Vol. 58 Issue 7 Pg. 967-976 (Jul 2019) ISSN: 1651-226X [Electronic] England
• PMID: 30994047 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents, Immunological
• Rituximab
• Methotrexate

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Agents, Immunological (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Austria (epidemiology)
• Brain Neoplasms (drug therapy, mortality)
• Female
• Follow-Up Studies
• Humans
• Lymphoma, Non-Hodgkin (drug therapy, mortality)
• Male
• Methotrexate (therapeutic use)
• Middle Aged
• Prognosis
• Progression-Free Survival
• Registries (statistics & numerical data)
• Rituximab (therapeutic use)
• Survival Analysis
• Young Adult