Defining optimal initial therapy for primary CNS lymphoma
Mené sur 219 patients atteints d'un lymphome primitif du système nerveux central, cet essai international randomisé de phase II évalue l'efficacité, du point de vue du taux de rémission complète, et la toxicité de l'ajout de rituximab, avec ou sans thiotépa, à un traitement combinant méthotrexate et cytarabine
Primary B-cell CNS lymphoma (PCNSL) is a rare disease, with an incidence of four new cases per million per year in the USA. The disease has at least two epidemiological subsets: immunocompromised patients in whom many cases are preceded by Epstein-Barr virus infection, and the more common setting of immunocompetent patients without known risk factors. In the past 25 years, outcomes of the latter subtype have improved modestly related to the inclusion of high-dose methotrexate in treatment regimens, which is the most active anti-PCNSL drug.