Evaluation of the Short-Term Efficacy and Safety of Orelabrutinib Combined with High-Dose Methotrexate in the First-line Treatment of Elderly Patients with High Risk Primary Central Nervous System Lymphoma.
10.19746/j.cnki.issn.1009-2137.2023.06.017
- Author:
Ying XIE
1
;
Shuang QU
1
;
Li-Sheng LIAO
1
;
Zhi-Hai ZHENG
1
;
Yun LIN
1
;
Wei-Min CHEN
1
;
Bi-Yun CHEN
2
Author Information
1. Department of Hematology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, Fujian Province, China.
2. Department of Hematology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, Fujian Province, China,E-mail：253934019@qq.com.
- Publication Type:Journal Article
- Keywords:
high-risk;
orelabrutinib;
primary central nervous system lymphoma;
safety;
short-term efficacy
- MeSH:
Humans;
Aged;
Methotrexate/adverse effects*;
Retrospective Studies;
Temozolomide/therapeutic use*;
Central Nervous System Neoplasms/drug therapy*;
Antineoplastic Combined Chemotherapy Protocols;
Lymphoma, Large B-Cell, Diffuse/drug therapy*;
Central Nervous System
- From:
Journal of Experimental Hematology
2023;31(6):1714-1719
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the short-term efficacy and adverse reactions of orelabrutinib combined with high-dose methotrexate (HD-MTX) in the first-line treatment of elderly high-risk primary central nervous system lymphoma (PCNSL), as well as the survival of patients.
METHODS:Twenty-five elderly patients with high-risk primary central nervous system diffuse large B-cell lymphoma admitted to Fujian Provincial Hospital from June 2016 to June 2022 were enrolled in this study, and complete clinical data from all patients were collected retrospectively, and the cut-off for follow-up was December 2022. 15 patients had received temmozolomide combined with HD-MTX regimen for at least four cycles, sequential lenalidomide maintenance therapy, while 10 patients had received orelabrutinib combined with HD-MTX regimen for at least four cycles, sequential orelabrutinib maintenance therapy. The short-term efficacy and adverse reactions of the two groups of patients after treatment were observed. Kaplan-Meier was used to analyze the progression-free survival (PFS) and time to progression (TTP).
RESULTS:The objective response rate (ORR) and 2-year median FPS of orelabrutinib combined with HD-MTX regimen group were similar to the temozolomide combined with HD-MTX regimen group (ORR: 100% vs 66.7%; 2-year median PFS: 16 months vs 15 months, P>0.05). The 2-year median TTP of the orelabrutinib+HD-MTX regimen group was better than that of the temozolomide+HD-MTX regimen group (not reached vs 12 months, P<0.05). There were no significant differences in adverse reactions such as gastrointestinal reactions, bone marrow suppression, liver and kidney damage, cardiotoxicity, pneumonia and bleeding between these two groups (P>0.05).
CONCLUSION:For elderly patients with high-risk PCNSL, orelabrutinib combined with HD-MTX has reliable short-term efficacy, good safety, and tolerable adverse reactions, which is worthy of clinical promotion.
