Primary Central Nervous System Lymphoma: The Memorial Sloan-Kettering Cancer Center Prognostic Model

2006 ◽  
Vol 24 (36) ◽  
pp. 5711-5715 ◽  
Author(s):  
Lauren E. Abrey ◽  
Leah Ben-Porat ◽  
Katherine S. Panageas ◽  
Joachim Yahalom ◽  
Brian Berkey ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Prognostic Score ◽  
Radiation Therapy Oncology Group ◽  
Primary Cns Lymphoma ◽  
Cancer Center ◽  
Karnofsky Performance Score ◽  
Newly Diagnosed ◽  
Data Set ◽  
Cut Point ◽  
Point Analysis

Purpose The purpose of this study was to analyze prognostic factors for patients with newly diagnosed primary CNS lymphoma (PCNSL) in order to establish a predictive model that could be applied to the care of patients and the design of prospective clinical trials. Patients and Methods Three hundred thirty-eight consecutive patients with newly diagnosed PCNSL seen at Memorial Sloan-Kettering Cancer Center (MSKCC; New York, NY) between 1983 and 2003 were analyzed. Standard univariate and multivariate analyses were performed. In addition, a formal cut point analysis was used to determine the most statistically significant cut point for age. Recursive partitioning analysis (RPA) was used to create independent prognostic classes. An external validation set obtained from three prospective Radiation Therapy Oncology Group (RTOG) PCNSL clinical trials was used to test the RPA classification. Results Age and performance status were the only variables identified on standard multivariate analysis. Cut point analysis of age determined that patients age ≤ 50 years had significantly improved outcome compared with older patients. RPA of 282 patients identified three distinct prognostic classes: class 1 (patients < 50 years), class 2 (patients ≥50; Karnofsky performance score [KPS] ≥ 70) and class 3 (patients ≥ 50; KPS < 70). These three classes significantly distinguished outcome with regard to both overall and failure-free survival. Analysis of the RTOG data set confirmed the validity of this classification. Conclusion The MSKCC prognostic score is a simple, statistically powerful model with universal applicability to patients with newly diagnosed PCNSL. We recommend that it be adopted for the management of newly diagnosed patients and incorporated into the design of prospective clinical trials.

Cancer clinical trials available in the community setting: A 5-year analysis from 1999–2004

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6056-6056
Author(s):  
J. K. Keller ◽  
J. Bowman ◽  
J. A. Lee ◽  
M. A. Mathiason ◽  
K. A. Frisby ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Community Setting ◽  
Disease Stage ◽  
Cancer Center ◽  
Newly Diagnosed ◽  
Community Based ◽  
Eligibility Criteria ◽  
Major Barrier

6056 Background: Less than 5% of newly diagnosed cancer patients are accrued into clinical trials. In the community setting, the lack of appropriate clinical trials is a major barrier. Our prospective study in 2004 determined that 58% of newly diagnosed adult cancer patients at our community-based cancer center didn’t have a clinical trial available appropriate for their disease stage. Among those with clinical trials, 23% were subsequently found to be ineligible (Go RS, et al. Cancer 2006, in press). However, the availability of clinical trials may vary from year to year. Methods: A retrospective study was conducted to determine what clinical trials were available for newly diagnosed adult cancer patients at our institution from June 1999-July 2004. The study also investigated the proportions of newly diagnosed patients who had a clinical trial available appropriate for type and stage of disease and patients accrued. Results: Over the 5-year period, 207 (82, 87, 99, 102, 117, years 1–5, respectively) trials were available. Most (50.7%) trials were for the following cancers: breast (15.5%), lung (13.5%), head and neck (7.7%), colorectal (7.2%) and lymphoma (6.8%). ECOG (53%), RTOG (26%), and CTSU (9%) provided the majority of the trials. A total of 5,776 new adult cancer patients were seen during this period. Overall, 60% of the patients had a trial available appropriate for type and stage of their cancer, but only 103 (3%) were enrolled. There was a significant upward trend in the proportions of patients with available trials over the years (60.2%, 55.9%, 59.2%, 60.7%, 63.9%, years 1–5, respectively; Mantel-Haenszel P=.008). The proportion of patients with a trial available was highest for prostate (97.3%), lung (90.9%), and breast (73.9%), and lowest for melanoma (17.1%), renal (11.6%), and bladder (7.2%). The majority of patients accrued to trials had the following cancers: breast (32%), lung (17%), lymphoma (9%), colon (7%), and prostate (5%). Conclusions: Nearly half of the newly diagnosed adult patients at our center had no trials available appropriate for type and stage of their cancers. It is likely that if strict clinical trial eligibility criteria were applied, approximately 2/3 of our patients would not be eligible for a clinical trial. No significant financial relationships to disclose.

scholarly journals Does Valproic Acid or Levetiracetam Improve Survival in Glioblastoma? A Pooled Analysis of Prospective Clinical Trials in Newly Diagnosed Glioblastoma

2016 ◽  
Vol 34 (7) ◽  
pp. 731-739 ◽  
Author(s):  
Caroline Happold ◽  
Thierry Gorlia ◽  
Olivier Chinot ◽  
Mark R. Gilbert ◽  
L. Burt Nabors ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Clinical Trials ◽  
Radiation Therapy ◽  
Drug Use ◽  
Antiepileptic Drug ◽  
Randomized Clinical Trials ◽  
Radiation Therapy Oncology Group ◽  
Gene Promoter ◽  
Newly Diagnosed ◽  
Newly Diagnosed Glioblastoma

Purpose Symptomatic epilepsy is a common complication of glioblastoma and requires pharmacotherapy. Several uncontrolled retrospective case series and a post hoc analysis of the registration trial for temozolomide indicated an association between valproic acid (VPA) use and improved survival outcomes in patients with newly diagnosed glioblastoma. Patients and Methods To confirm the hypothesis suggested above, a combined analysis of survival association of antiepileptic drug use at the start of chemoradiotherapy with temozolomide was performed in the pooled patient cohort (n = 1,869) of four contemporary randomized clinical trials in newly diagnosed glioblastoma: AVAGlio (Avastin in Glioblastoma; NCT00943826), CENTRIC (Cilengitide, Temozolomide, and Radiation Therapy in Treating Patients With Newly Diagnosed Glioblastoma and Methylated Gene Promoter Status; NCT00689221), CORE (Cilengitide, Temozolomide, and Radiation Therapy in Treating Patients With Newly Diagnosed Glioblastoma and Unmethylated Gene Promoter Status; NCT00813943), and Radiation Therapy Oncology Group 0825 (NCT00884741). Progression-free survival (PFS) and overall survival (OS) were compared between: (1) any VPA use and no VPA use at baseline or (2) VPA use both at start of and still after chemoradiotherapy. Results of Cox regression models stratified by trial and adjusted for baseline prognostic factors were analyzed. The same analyses were performed with levetiracetam (LEV). Results VPA use at start of chemoradiotherapy was not associated with improved PFS or OS compared with all other patients pooled (PFS: hazard ratio [HR], 0.91; 95% CI, 0.77 to 1.07; P = .241; OS: HR, 0.96; 95% CI, 0.80 to 1.15; P = .633). Furthermore, PFS and OS of patients taking VPA both at start of and still after chemoradiotherapy were not different from those without antiepileptic drug use at both time points (PFS: HR, 0.92; 95% CI, 0.74 to 1.15; P = .467; OS: HR, 1.10; 95% CI, 0.86 to 1.40; P = .440). Similarly, no association with improved outcomes was observed for LEV use. Conclusion The results of this analysis do not justify the use of VPA or LEV for reasons other than seizure control in patients with newly diagnosed glioblastoma outside clinical trials.

scholarly journals Comprehensive Clinical and Molecular Characterization of KRASG12C-Mutant Colorectal Cancer

2021 ◽  
pp. 613-621
Author(s):  
Jason T. Henry ◽  
Oluwadara Coker ◽  
Saikat Chowdhury ◽  
John Paul Shen ◽  
Van K. Morris ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Trials ◽  
De Novo ◽  
Expression Profiles ◽  
Single Gene ◽  
Gene Expression Profiles ◽  
Progression Free Survival ◽  
Cancer Center ◽  
Data Set ◽  
External Data

PURPOSE KRAS p.G12C mutations occur in approximately 3% of metastatic colorectal cancers (mCRC). Recently, two allosteric inhibitors of KRAS p.G12C have demonstrated activity in early phase clinical trials. There are no robust studies examining the behavior of this newly targetable population. METHODS We queried the MD Anderson Cancer Center data set for patients with colorectal cancer who harbored KRAS p.G12C mutations between January 2003 and September 2019. Patients were analyzed for clinical characteristics, overall survival (OS), and progression-free survival (PFS) and compared against KRAS nonG12C. Next, we analyzed several internal and external data sets to assess immune signatures, gene expression profiles, hypermethylation, co-occurring mutations, and proteomics. RESULTS Among the 4,632 patients with comprehensive molecular profiling, 134 (2.9%) were found to have KRAS p.G12C mutations. An additional 53 patients with single gene sequencing were included in clinical data but excluded from prevalence analysis allowing for 187 total patients. Sixty-five patients had de novo metastatic disease and received a median of two lines of chemotherapy without surgical intervention. For the first three lines of chemotherapy, the median PFS was 6.4 months (n = 65; 95% CI, 5.0 to 7.4 months), 3.9 months (n = 47; 95% CI, 2.9 to 5.9 months), and 3.0 months (n = 21; 95% CI, 2.0 to 3.4 months), respectively. KRAS p.G12C demonstrated higher rates of basal EGFR activation compared with KRAS nonG12C. When compared with an internal cohort of KRAS nonG12C, KRAS p.G12C patients had worse OS. CONCLUSION PFS is poor for patients with KRAS p.G12C metastatic colorectal cancer. OS was worse in KRAS p.G12C compared with KRAS nonG12C patients. Our data highlight the innate resistance to chemotherapy for KRAS p.G12C patients and serve as a historical comparator for future clinical trials.

Poor access to clinical trials among community cancer patients requiring chemotherapy for recurrent or progressive disease: Limitations of current cancer cooperative groups

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6076-6076 ◽  
Author(s):  
L. A. Meyer ◽  
J. A. Lee ◽  
M. A. Mathiason ◽  
K. A. Frisby ◽  
K. C. Bruden ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cancer Patients ◽  
Progressive Disease ◽  
Cancer Center ◽  
Cooperative Groups ◽  
Newly Diagnosed ◽  
Poor Access ◽  
Accrual Rate ◽  
Clinical Trial Accrual ◽  
A Prospective Study

6076 Background: Data on clinical trial accrual among cancer patients treated in the community are limited. In a prospective study at our community-based cancer center, we found that the accrual rate was only 4% for newly diagnosed patients and protocol limitations accounted for 68% of non-accrual (Go RS, et al. Cancer 2006). We would like to determine the availability of trials for adult cancer patients with recurrent or progressive disease treated in the community and the accrual rate. Methods: We retrospectively identified this specific group of patients who received chemotherapy at our institution between November 2004 and October 2005 and collected data on the number, types, and sources of trials that were available. Results: We identified a total of 140 patients. There was an equal number of females (52.9%) and males, with a median age of 66 years (range, 38–89) at the time of chemotherapy. Fifty trials were available, with about half for the following cancers: lung (14%), pancreatic (12%), renal (10%), head and neck (8%), prostate (6%), and breast (6%). No trials were available for bladder, colorectal, and gastroesophageal cancers. The proportions of phase I, II, and III trials were 4%, 62%, and 34%, respectively. The sources of trials were: ECOG (56%), Wisconsin Oncology Network (14%), Intergroup (12%), GOG (10%), RTOG (2%), CTSU (2%), our institution (2%), and pharmaceutical companies (2%). Only 69 (49.3%) patients had trials appropriate for their type and stage of cancers. Among those patients with available trials, 24 (34.8%) were eligible to participate and 6 were enrolled, for an overall accrual rate of 4.3%. There were no differences in age and sex among subgroups in terms of trial availability, eligibility, and accrual. Conclusions: At our institution, enrollment of cancer patients with recurrent or progressive disease in clinical trials is as low as for newly diagnosed patients. Over 80% of the patients were denied access to a trial because of protocol unavailability and ineligibility. Current cancer cooperative groups do not provide adequate trials for patients in the community. No significant financial relationships to disclose.

Perceptions concerning clinical trials in oncology patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16533-e16533
Author(s):  
Dana Lee ◽  
Ju-Hsien Chao ◽  
Sandy Stevens ◽  
Goetz H. Kloecker
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Treatment Option ◽  
Phase 1 ◽  
Cancer Center ◽  
Line Treatment ◽  
Newly Diagnosed ◽  
First Line ◽  
Oncology Patients

e16533 Background: Accrual to clinical trials among adult cancer patients is persistently low. Patient preference plays an important role in enrollment. To identify the reasons why patients decline study participation, it is important, to evaluate the perceptions of newly diagnosed oncology patients about clinical trials. Methods: Patients were given a ten-question survey reflective of their attitudes regarding clinical trials as a treatment option at their initial visit. The self-directed questionnaire was scored on an ordinate scale from strongly agree (1) to strongly disagree (5). Results: Ninety-two new patients were surveyed in the cancer - specific multispecialty clinics in an academic cancer center. The patients expected information relating to eligible clinical trials and privacy protection by university sponsored studies as they strongly concurred with “I expect my doctor to inform me about clinical trials that I am eligible for” (mean score 2.15, p=0.001) followed by “all possible measures to protect my privacy are likely to be taken in a clinical trial that is sponsored by a university” (2.36, p=0.36). The strongest disagreement was “If enrolled in a clinical trial, I am comfortable being assigned by a method such as ‘flipping a coin’ or ‘throwing a dice’” (3.73, p=0.001) and “I would be willing to participate in a clinical trial as a first line treatment option” (3.50, p=0.001). Industry sponsored trials, phase 1 trials, second line treatment trials, privacy concerns and investigator initiated trials and time commitment and altruistic reasons did not significantly deviate from the mean preference (2.5) by a one sample T-test analysis. Conclusions: Patients consider the option of clinical trials as important in their treatment, and expect to be informed by their oncologist about clinical trials. Newly diagnosed cancer patients perceive randomization and first line trials negatively. Since randomized data provides new standards for care and hope for improved treatment, patients and their families must be educated about their importance.

scholarly journals Blood-Brain Barrier Disruption and Intra-Arterial Methotrexate-Based Therapy for Newly Diagnosed Primary CNS Lymphoma: A Multi-Institutional Experience

2009 ◽  
Vol 27 (21) ◽  
pp. 3503-3509 ◽  
Author(s):  
Lilyana Angelov ◽  
Nancy D. Doolittle ◽  
Dale F. Kraemer ◽  
Tali Siegal ◽  
Gene H. Barnett ◽  
...  
Keyword(s):  
Blood Brain Barrier ◽  
Primary Cns Lymphoma ◽  
Whole Brain Radiotherapy ◽  
Brain Barrier ◽  
Tumor Control ◽  
Cns Lymphoma ◽  
Karnofsky Performance Score ◽  
Newly Diagnosed ◽  
Blood Brain ◽  
Institutional Experience

Purpose Primary CNS lymphoma (PCNSL) is confined to the CNS and/or the eyes at presentation and is usually initially treated with intravenous methotrexate-based chemotherapy and whole-brain radiotherapy (WBRT). However, the intact blood-brain barrier (BBB) can limit diffusion of methotrexate into brain and tumor. With BBB disruption (BBBD), enhanced drug delivery to the tumor can be achieved. Patients and Methods This report summarizes the multi-institutional experience of 149 newly diagnosed (with no prior WBRT) patients with PCNSL treated with osmotic BBBD and intra-arterial (IA) methotrexate at four institutions from 1982 to 2005. In this series, 47.6% of patients were age ≥ 60 years, and 42.3% had Karnofsky performance score (KPS) less than 70 at diagnosis. Results The overall response rate was 81.9% (57.8% complete; 24.2% partial). Median overall survival (OS) was 3.1 years (25% estimated survival at 8.5 years). Median progression-free survival (PFS) was 1.8 years, with 5-year PFS of 31% and 7-year PFS of 25%. In low-risk patients (age < 60 years and KPS ≥ 70), median OS was approximately 14 years, with a plateau after approximately 8 years. Procedures were generally well tolerated; focal seizures (9.2%) were the most frequent side effect and lacked long-term sequelae. Conclusion This large series of patients treated over a 23-year period demonstrates that BBBD/IA methotrexate-based chemotherapy results in successful and durable tumor control and outcomes that are comparable or superior to other PCNSL treatment regimens.

scholarly journals HOUT-18. TREATMENT STRATEGIES FOR GLIOBLASTOMA IN OLDER PATIENTS: AGE IS JUST A NUMBER

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi115-vi116
Author(s):  
Michael Youssef ◽  
Ethan Ludmir ◽  
Jacob Mandel ◽  
Akash Patel ◽  
Ali Jalali ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Trials ◽  
Multivariable Analysis ◽  
Treatment Strategies ◽  
Retrospective Chart Review ◽  
High Volume ◽  
Cancer Center ◽  
Newly Diagnosed ◽  
Optimal Care ◽  
Poor Overall Survival

Abstract BACKGROUND Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in clinical trials (including EORTC 22981) as well as their historically-poor overall survival. METHODS Retrospective chart review was conducted at a single high-volume cancer center for newly-diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. RESULTS A total of 158 newly-diagnosed GBM patients aged 65 years and older were identified. 144 patients (91.1%) underwent radiation therapy. One-hundred thirty patient (90.3%) received concurrent temozolomide with radiotherapy. A minority of patients (23%) discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temodar. The median overall survival (OS) time for our cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p=0.002, HR 0.46; 95% CI: 0.63–0.82), completing planned course of radiation (p=0.01, HR 0.29; 95% CI: 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p=0.01, HR 2.62; 95% CI: 1.67–4.12) were associated with improved OS. CONCLUSIONS Our cohort of elderly GBM patients were predominately treated with a standard of care based on EORTC 22981. Despite their age, these patients tolerated treatment well and had a favorable overall survival compared to outcomes reported for patients treated on EORTC 22981. Using age alone as the reason to de-escalate treatment or as an exclusionary criteria in clinical trials should be discouraged.

Combination Chemotherapy and Radiotherapy for Primary Central Nervous System Lymphoma: Radiation Therapy Oncology Group Study 93-10

2002 ◽  
Vol 20 (24) ◽  
pp. 4643-4648 ◽  
Author(s):  
Lisa M. DeAngelis ◽  
Wendy Seiferheld ◽  
S. Clifford Schold ◽  
Barbara Fisher ◽  
Christopher J. Schultz
Keyword(s):  
Combination Chemotherapy ◽  
Response Rate ◽  
Radiation Therapy Oncology Group ◽  
Primary Cns Lymphoma ◽  
Central Nervous System Lymphoma ◽  
Cranial Irradiation ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Newly Diagnosed ◽  
Dose Methotrexate

PURPOSE: Primary CNS lymphoma (PCNSL) is an aggressive primary brain tumor. Cranial irradiation alone rarely results in long-term disease control or prolonged survival. We prospectively studied the use of combination chemotherapy plus cranial irradiation in newly diagnosed patients with PCNSL. PATIENTS AND METHODS: We enrolled 102 newly diagnosed, immunocompetent patients with PCNSL; 98 were assessable. Patients first received five cycles of methotrexate 2.5 g/m2, vincristine, procarbazine, and intraventricular methotrexate (12 mg). Whole-brain radiotherapy (RT) was administered to a total dose of 45 Gy and all patients received high-dose cytarabine after RT. RESULTS: Fifty-eight percent of patients with measurable disease had a complete response to preirradiation chemotherapy and 36% had a partial (> 50%) response, for a 94% response rate. Median progression-free survival was 24.0 months and overall survival was 36.9 months. Age was an important prognostic factor; median survival was 50.4 months in patients younger than 60 and only 21.8 months in those aged 60 or older (P < .001). Fifty-three percent of patients had grade 3 or 4 toxicity during induction chemotherapy, half of which was hematologic. However, 12 patients (15%) experienced severe delayed neurologic toxicity, eight of whom died. CONCLUSION: This is the first multicenter trial demonstrating improved survival with the combination of chemotherapy plus RT compared with previous reports of RT alone. A high-dose methotrexate-based regimen produced a high response rate before RT was administered. High-dose methotrexate combined with cranial irradiation is an effective therapeutic approach to PCNSL, but neurotoxicity is a delayed risk of this approach.

The Relapsed - Memorial Sloan - Kettering Cancer Center (R-MSKCC) Prognostic Score Is a Risk-Stratification Model for the Central Nervous System (CNS) Involvement at Relapse in Patients with Diffuse Large B Cell Lymphoma (DLBCL) in the Rituximab Era

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4221-4221
Author(s):  
Noriko Nishimura ◽  
Yasuhito Terui ◽  
Kengo Takeuchi ◽  
Naoko Tsuyama ◽  
Anna Takahashi ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cell Lymphoma ◽  
Prognostic Score ◽  
B Cell Lymphoma ◽  
Cancer Center ◽  
Newly Diagnosed ◽  
Cns Involvement ◽  
Large B Cell Lymphoma ◽  
To Receive

Abstract Background: Introduction of Rituximab has shown a remarkable improvement on survival for the patients with diffuse Large B cell Lymphoma (DLBCL). However, involvement of central nervous system (CNS) at relapse in these patients is still an issue and a mostly fatal with a median survival of 2.5 - 4 months when they treated with conventional therapies. The Memorial Sloan - Kettering Cancer Center (MSKCC) prognostic score has been used as a statistically powerful model to patients with newly diagnosed primary central nervous system lymphoma (PCNSL) before rituximab introduction. By contrast, effective prognostic model for the relapsed DLBCL patients with CNS involvement in the rituximab era is unclear. The purpose of this study was to address treatment response and detailed prognosis of CNS recurrence of DLBCL after initial treatment with Rituximab contained chemotherapy. Patients and Methods: In total, 560 newly diagnosed de novo DLBCL patients treated with R- Results: Among the 25 patients assessed in this study, median age was 61 years (range, 34-81 years) at relapse.Sixteen (64%) patients were male. Primary sites at initial diagnosis were mostly extra-nodal sites such as nasal cavity, paranasal sinuses, skin, primary effusion, breasts, testes, ovaries, gastro-intestine, kidneys, adrenal glands, and bone in 88% (22/25) of the patients. The cell of origin of germinal center (GC) subtype by Hans algorithm were shown in 47.6% (10/25). All patients other than one with stage I were to receive 6 to 8 cycles of R-CHOP and the patient with stage I were to receive combined modality therapy with 3 cycles of R-CHOP followed by involved field radiation therapy as an initial treatment. Only two patients received intrathecal prophylaxis. The median interval between the initial diagnosis and CNS relapse was 22 months (range, 1-100 months). The patients status at relapse were 44% of (11/25) first complete response (CR), 32% of (8/25) first partial response (PR), 20% (5/25) of second CR, and 4% (1/25) of second PR after the latest chemotherapy. There were 15 patients (60%) with brain intra- parenchymal lesions identified by brain imaging and the others (40%) with leptomeningeal infiltration revealed with cerebrospinal fluid analysis. Front-line treatment for relapse at CNS lesion was chemotherapy with or without whole brain radiotherapy (WBRT) in 13 patients (52%). A total of 6 patients (24%) received WBRT without chemotherapy. The others received the best supportive care. In addition, most patients through those three groups received intrathecal chemotherapy with MTX, Ara-C, and prednisone. The median overall survival (OS) after CNS relapse was 7 months (95% CI: 5-12) for the whole population, 12 months for chemotherapy group, 6.5 months for WBRT group, and 2 months for BSC group (p = 0.02). To date 22 patients (88%) had died. At univariate analysis significant prognostic factors for overall survival were age at relapse (P=0.02), elevated b2- microglobulin (b2-MG) (p=0.03), and response for the latest chemotherapy (p=0.01) that was only a significant factor in multivariate analysis. Thus we established Relapsed-MSKCC prognostic score consisting of age < 50, KPS >=70, and response for the latest chemotherapy; add 1 to MSKCC score if they did not achieve CR after the latest therapy. The median OS in patients with a R-MSKCC prognostic score of 1 was not reached, and differed significantly from the 13 months in patients with a R-MSKCC score of 2, 8 months in patients with a R-MSKCC score of 3, and 2 months in patients with a R-MSKCC score of 4 (P=0.01). Conclusions: The Survival of CNS recurrence in patients with DLBCL remains lethal. R-MSKCC prognostic score may predict survival better in these patients. Figure Figure. Disclosures Nishimura: Chugai pharmaceutical co.LTD: Consultancy. Terui:Yanssen: Honoraria. Mishima:Chugai: Consultancy. Yokoyama:Chugai: Consultancy. Hatake:Meiji-Seika: Consultancy; Kyowa Kirin: Honoraria, Research Funding; Otsuka: Consultancy; Chugai: Research Funding.

scholarly journals A new prognostic score for disease progression and mortality in patients with newly diagnosed primary CNS lymphoma

2020 ◽  
Vol 9 (6) ◽  
pp. 2134-2145 ◽  
Author(s):  
Chia‐Jen Liu ◽  
Shinn‐Yn Lin ◽  
Ching‐Fen Yang ◽  
Chiu‐Mei Yeh ◽  
Ai‐Seon Kuan ◽  
...  
Keyword(s):  
Disease Progression ◽  
Prognostic Score ◽  
Primary Cns Lymphoma ◽  
Cns Lymphoma ◽  
Newly Diagnosed
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