CNS border posts against rituximab?
Mené aux Pays-Bas, en Australie et en Nouvelle-Zélande sur 200 patients atteints d'un lymphome primitif du système nerveux central récemment diagnostiqué (âge médian : 61 ans), cet essai de phase III évalue l'efficacité, du point de vue de la survie sans événement, et la toxicité de l'ajout du rituximab à une chimiothérapie comportant de hautes doses de méthotrexate (durée médiane de suivi : 32,9 mois)
Rituximab, an antibody that targets CD20, is a standard treatment for non-Hodgkin B-cell lymphomas, including systemic diffuse large B-cell lymphoma. Treatment of non-Hodgkin B-cell lymphoma with rituximab leads, almost without exception, to improvements in disease response and survival. Primary CNS lymphoma is a diffuse large B-cell lymphoma that is confined to the CNS compartment, without any systemic manifestation. In contrast to the established R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) protocol used to treat systemic diffuse large B-cell lymphoma, treatment protocols for primary CNS lymphoma vary, although intravenous high-dose methotrexate is widely accepted as a fundamental component. There has been substantial debate as to whether intravenous rituximab sufficiently accumulates in the CNS to exert its full potential in primary CNS lymphoma.
The Lancet Oncology , commentaire, 2018