Maintenance Treatment Versus Observation in Elderly Patients With PCNS Lymphoma
Status:
Recruiting
Trial end date:
2022-06-01
Target enrollment:
Participant gender:
Summary
Hypothesis
Our hypothesis is that maintenance chemotherapy will prolong complete remission obtained
after a standard induction chemotherapy with an acceptable toxicity in the elderly.
Rationale
- Treatment of the elderly is challenging, indeed age over 60 is associated both with a
poor prognosis and a high risk of treatment induced neurotoxicity with devastating
consequences on quality of life. Therefore it has become standard practice to treat
elderly in first line with high-dose methotrexate (MTX) based polychemotherapy alone,
avoiding whole brain radiotherapy (WBRT) or deferring it for recurrence.
- There is a clear need to improve disease control after induction chemotherapy. Since
consolidation with WBRT or intensive chemotherapy with autologous stem cell rescue are
either poorly effective and/or too toxic in the elderly population, maintenance
chemotherapy is an interesting alternative approach. Several agents, such as high-dose
MTX, temozolomide (TMZ), rituximab, with a reported activity in PCNSL and acceptable
safety profile, as single agent or combined, are good candidates for maintenance