First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial
There are limited data from prospective controlled trials regarding optimal treatment strategies in patients with primary breast diffuse large B-cell lymphoma (DLBCL). In this phase 2 study (NCT01448096), we examined the efficacy and safety of standard immunochemotherapy and central nervous system (...
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| Format: | Article |
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MDPI AG
2020-08-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/8/2192 |
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| author | Ho-Young Yhim Dok Hyun Yoon Seok Jin Kim Deok-Hwan Yang Hyeon-Seok Eom Kyoung Ha Kim Yong Park Jin Seok Kim Hyo Jung Kim Cheolwon Suh Won Seog Kim Jae-Yong Kwak |
| author_facet | Ho-Young Yhim Dok Hyun Yoon Seok Jin Kim Deok-Hwan Yang Hyeon-Seok Eom Kyoung Ha Kim Yong Park Jin Seok Kim Hyo Jung Kim Cheolwon Suh Won Seog Kim Jae-Yong Kwak |
| author_sort | Ho-Young Yhim |
| collection | DOAJ |
| description | There are limited data from prospective controlled trials regarding optimal treatment strategies in patients with primary breast diffuse large B-cell lymphoma (DLBCL). In this phase 2 study (NCT01448096), we examined the efficacy and safety of standard immunochemotherapy and central nervous system (CNS) prophylaxis using intrathecal methotrexate (IT-MTX). Thirty-three patients with newly diagnosed primary breast DLBCL received six cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and four fixed doses of IT-MTX (12 mg). The median age was 50 years (range, 29–75), and all patients were females. According to the CNS-International Prognostic Index, most patients (<i>n</i> = 28) were categorized as the low-risk group. Among the 33 patients, 32 completed R-CHOP, and 31 completed IT-MTX as planned. With a median follow-up of 46.1 months (interquartile range (IQR), 31.1–66.8), the 2-year progression-free and overall survival rates were 81.3% and 93.5%, respectively. Six patients experienced treatment failures, which included the CNS in four patients (two parenchyma and two leptomeninges) and breast in two patients (one ipsilateral and one contralateral). The 2-year cumulative incidence of CNS relapse was 12.5%. Although standard R-CHOP and IT-MTX without routine radiotherapy show clinically meaningful survival outcomes, this strategy may not be optimal for reducing CNS relapse and warrants further investigation. |
| first_indexed | 2024-03-10T17:54:07Z |
| format | Article |
| id | doaj.art-b5bc7c5189094769a3d7eb4562735341 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T17:54:07Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-b5bc7c5189094769a3d7eb45627353412023-11-20T09:14:56ZengMDPI AGCancers2072-66942020-08-01128219210.3390/cancers12082192First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 TrialHo-Young Yhim0Dok Hyun Yoon1Seok Jin Kim2Deok-Hwan Yang3Hyeon-Seok Eom4Kyoung Ha Kim5Yong Park6Jin Seok Kim7Hyo Jung Kim8Cheolwon Suh9Won Seog Kim10Jae-Yong Kwak11Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju 54907, KoreaDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, KoreaDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Internal Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do 58128, KoreaCenter for Hematologic Malignancy, National Cancer Center, Goyang 10408, KoreaDepartment of Internal Medicine, Soonchunhyang University College of Medicine, Seoul 04401, KoreaDepartment of Internal Medicine, Anam Hospital, Korea University College of Medicine, Seoul 02841, KoreaDepartment of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, KoreaDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, KoreaDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Internal Medicine, Jeonbuk National University Medical School, Jeonju 54907, KoreaThere are limited data from prospective controlled trials regarding optimal treatment strategies in patients with primary breast diffuse large B-cell lymphoma (DLBCL). In this phase 2 study (NCT01448096), we examined the efficacy and safety of standard immunochemotherapy and central nervous system (CNS) prophylaxis using intrathecal methotrexate (IT-MTX). Thirty-three patients with newly diagnosed primary breast DLBCL received six cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and four fixed doses of IT-MTX (12 mg). The median age was 50 years (range, 29–75), and all patients were females. According to the CNS-International Prognostic Index, most patients (<i>n</i> = 28) were categorized as the low-risk group. Among the 33 patients, 32 completed R-CHOP, and 31 completed IT-MTX as planned. With a median follow-up of 46.1 months (interquartile range (IQR), 31.1–66.8), the 2-year progression-free and overall survival rates were 81.3% and 93.5%, respectively. Six patients experienced treatment failures, which included the CNS in four patients (two parenchyma and two leptomeninges) and breast in two patients (one ipsilateral and one contralateral). The 2-year cumulative incidence of CNS relapse was 12.5%. Although standard R-CHOP and IT-MTX without routine radiotherapy show clinically meaningful survival outcomes, this strategy may not be optimal for reducing CNS relapse and warrants further investigation.https://www.mdpi.com/2072-6694/12/8/2192central nervous systemdiffuse large B-cell lymphomaprimary breast lymphomaprophylaxisrituximab |
| spellingShingle | Ho-Young Yhim Dok Hyun Yoon Seok Jin Kim Deok-Hwan Yang Hyeon-Seok Eom Kyoung Ha Kim Yong Park Jin Seok Kim Hyo Jung Kim Cheolwon Suh Won Seog Kim Jae-Yong Kwak First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial Cancers central nervous system diffuse large B-cell lymphoma primary breast lymphoma prophylaxis rituximab |
| title | First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
| title_full | First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
| title_fullStr | First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
| title_full_unstemmed | First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
| title_short | First-Line Treatment for Primary Breast Diffuse Large B-Cell Lymphoma Using Immunochemotherapy and Central Nervous System Prophylaxis: A Multicenter Phase 2 Trial |
| title_sort | first line treatment for primary breast diffuse large b cell lymphoma using immunochemotherapy and central nervous system prophylaxis a multicenter phase 2 trial |
| topic | central nervous system diffuse large B-cell lymphoma primary breast lymphoma prophylaxis rituximab |
| url | https://www.mdpi.com/2072-6694/12/8/2192 |
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