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First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial
There are limited data from prospective controlled trials regarding optimal treatment strategies in patients with primary breast diffuse large B-cell lymphoma (DLBCL). In this phase 2 study (NCT01448096), we examined the efficacy and safety of standard immunochemotherapy and central nervous system (...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463683/ https://www.ncbi.nlm.nih.gov/pubmed/32781541 http://dx.doi.org/10.3390/cancers12082192 |
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author | Yhim, Ho-Young Yoon, Dok Hyun Kim, Seok Jin Yang, Deok-Hwan Eom, Hyeon-Seok Kim, Kyoung Ha Park, Yong Kim, Jin Seok Kim, Hyo Jung Suh, Cheolwon Kim, Won Seog Kwak, Jae-Yong |
author_facet | Yhim, Ho-Young Yoon, Dok Hyun Kim, Seok Jin Yang, Deok-Hwan Eom, Hyeon-Seok Kim, Kyoung Ha Park, Yong Kim, Jin Seok Kim, Hyo Jung Suh, Cheolwon Kim, Won Seog Kwak, Jae-Yong |
author_sort | Yhim, Ho-Young |
collection | PubMed |
description | There are limited data from prospective controlled trials regarding optimal treatment strategies in patients with primary breast diffuse large B-cell lymphoma (DLBCL). In this phase 2 study (NCT01448096), we examined the efficacy and safety of standard immunochemotherapy and central nervous system (CNS) prophylaxis using intrathecal methotrexate (IT-MTX). Thirty-three patients with newly diagnosed primary breast DLBCL received six cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and four fixed doses of IT-MTX (12 mg). The median age was 50 years (range, 29–75), and all patients were females. According to the CNS-International Prognostic Index, most patients (n = 28) were categorized as the low-risk group. Among the 33 patients, 32 completed R-CHOP, and 31 completed IT-MTX as planned. With a median follow-up of 46.1 months (interquartile range (IQR), 31.1–66.8), the 2-year progression-free and overall survival rates were 81.3% and 93.5%, respectively. Six patients experienced treatment failures, which included the CNS in four patients (two parenchyma and two leptomeninges) and breast in two patients (one ipsilateral and one contralateral). The 2-year cumulative incidence of CNS relapse was 12.5%. Although standard R-CHOP and IT-MTX without routine radiotherapy show clinically meaningful survival outcomes, this strategy may not be optimal for reducing CNS relapse and warrants further investigation. |
format | Online Article Text |
id | pubmed-7463683 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-74636832020-09-02 First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial Yhim, Ho-Young Yoon, Dok Hyun Kim, Seok Jin Yang, Deok-Hwan Eom, Hyeon-Seok Kim, Kyoung Ha Park, Yong Kim, Jin Seok Kim, Hyo Jung Suh, Cheolwon Kim, Won Seog Kwak, Jae-Yong Cancers (Basel) Article There are limited data from prospective controlled trials regarding optimal treatment strategies in patients with primary breast diffuse large B-cell lymphoma (DLBCL). In this phase 2 study (NCT01448096), we examined the efficacy and safety of standard immunochemotherapy and central nervous system (CNS) prophylaxis using intrathecal methotrexate (IT-MTX). Thirty-three patients with newly diagnosed primary breast DLBCL received six cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and four fixed doses of IT-MTX (12 mg). The median age was 50 years (range, 29–75), and all patients were females. According to the CNS-International Prognostic Index, most patients (n = 28) were categorized as the low-risk group. Among the 33 patients, 32 completed R-CHOP, and 31 completed IT-MTX as planned. With a median follow-up of 46.1 months (interquartile range (IQR), 31.1–66.8), the 2-year progression-free and overall survival rates were 81.3% and 93.5%, respectively. Six patients experienced treatment failures, which included the CNS in four patients (two parenchyma and two leptomeninges) and breast in two patients (one ipsilateral and one contralateral). The 2-year cumulative incidence of CNS relapse was 12.5%. Although standard R-CHOP and IT-MTX without routine radiotherapy show clinically meaningful survival outcomes, this strategy may not be optimal for reducing CNS relapse and warrants further investigation. MDPI 2020-08-06 /pmc/articles/PMC7463683/ /pubmed/32781541 http://dx.doi.org/10.3390/cancers12082192 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Yhim, Ho-Young Yoon, Dok Hyun Kim, Seok Jin Yang, Deok-Hwan Eom, Hyeon-Seok Kim, Kyoung Ha Park, Yong Kim, Jin Seok Kim, Hyo Jung Suh, Cheolwon Kim, Won Seog Kwak, Jae-Yong First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
title | First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
title_full | First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
title_fullStr | First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
title_full_unstemmed | First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
title_short | First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
title_sort | first-line treatment for primary breast diffuse large b-cell lymphoma using immunochemotherapy and central nervous system prophylaxis: a multicenter phase 2 trial |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463683/ https://www.ncbi.nlm.nih.gov/pubmed/32781541 http://dx.doi.org/10.3390/cancers12082192 |
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