Newly diagnosed primary central nervous system lymphoma: Ibrutinib-based combination therapy has exhibited therapeutic benefit
Ibrutinib ( Imbruvica ) has shown single-agent activity in relapse / refractory ( R/R ) primary central nervous system lymphoma ( PCNSL ), and the high dose Methotrexate ( HD-MTX ) has been the backbone of treatment of de-novo PCNSLs.
Combination therapy of HD-Methotrexate and Ibrutinib has recently shown activity in R/R PCNSLs.
Eleven newly diagnosed patients with primary central nervous system lymphoma who underwent combination therapy of HD-Methotrexate and Ibrutinib were analyzed for treatment response and safety profile.
HD-Methotrexate was given at 3.5 g/m2 every 2 weeks for a total of 8 doses.
Ibrutinib was held on days of HD-Methotrexate infusion until HD-Methotrexate clearance. Single-agent daily Ibrutinib was administered continuously after completion of induction therapy until disease progression, intolerable toxicity, or death.
Patients’ clinicopathologic characteristics were retrospectively reviewed and genomic traits were further analyzed.
Nine out of 11 patients have completed the induction phase of Ibrutinib-based combination therapy and received Ibrutinib maintenance in addition to two patients whose disease progressed during the therapy.
An objective response rate ( ORR ) of 82% ( 9/11 ) was observed, including 7 patients with complete response ( CR, 64% ) and 2 patients with partial response ( PR, 18% ).
The median progression-free survival ( PFS ) was 7.4 months while the median overall survival ( OS ) was not reached.
The combination therapy of HD-Methotrexate and Ibrutinib was well tolerated and has acceptable safety.
In addition, the presence of circulating tumor DNA ( ctDNA ) in cerebrospinal fluid ( CSF ) samples closely correlated with tumor response.
Sustained tumor responses were associated with the clearance of ctDNA from the CSF.
In conclusion, combination of Ibrutinib and HD-Methotrexate has acceptable safety and has demonstrated anti-tumor activity in newly diagnosed de-novo patients with primary central nervous system lymphoma.
The detection of ctDNA in CSF is feasible for monitoring tumor burden in PCNSL patients. ( Xagena )
Source: American Society of Clinical Oncology ( ASCO ) Virtual Meeting, 2020
Resected stage III melanoma with BRAF mutations: 5-year follow-up of adjuvant Dabrafenib plus Trametinib - Findings from the COMBI-AD study
Data from the five-year analysis featuring extended follow-up from the phase III COMBI-AD study have confirmed that 12 months of...
Efficacy and safety of Pembrolizumab plus chemotherapy to Pembrolizumab monotherapy: a consecutive analysis of NSCLC patients with high PD-L1 expression
There has been an only indirect comparison between Pembrolizumab ( Keytruda ) and Pembrolizumab plus chemotherapy in patients with non-small...
Primary Ipilimumab / Nivolumab immunotherapy followed by adjuvant Nivolumab in locally advanced or oligometastatic melanoma: preliminary results
The aim of neo-adjuvant therapy in locally advanced or oligometastatic melanoma is to facilitate radical resection, improve outcomes and undertake...
ALEX study: updated overall survival and final progression-free survival data for patients with treatment-naive advanced ALK-positive non-small-cell lung cancer
The ALEX study has demonstrated significantly improved progression-free survival ( PFS ) with Alectinib ( Alecensa ) versus Crizotinib (...
In the absence of effective vaccines and with limited therapeutic options, convalescent plasma is being collected across the globe for...
The mRNA-1273 vaccine for SARS-CoV-2 is tolerable and immunogenic in older adults. Data on prolonged immunogenicity and effectiveness in preventing severe...
Ayvakyt for the treatment of adults with unresectable or metastatic PDGFRA D842V mutant gastrointestinal stromal tumors, approved by European Commission
The European Commission ( EC ) has granted conditional marketing authorization to Ayvakyt ( Avapritinib ) as a monotherapy for...
The U.S. Food and Drug Administration ( FDA ) has approved Gallium 68 PSMA-11 ( Ga 68 PSMA-11 ), the...
FDA has approved Ayvakit, the first targeted therapy to treat a rare mutation in patients with gastrointestinal stromal tumors
The FDA ( U.S. Food and Drug Administration ) has approved Ayvakit ( Avapritinib ) for the treatment of adults...
European Commission has approved expanded use of Erleada for treatment of patients with metastatic hormone-sensitive prostate cancer
The European Commission ( EC ) has granted marketing authorisation for the expanded use of Erleada ( Apalutamide ) to...