Methotrexate single drug cures 20% PCNSL

Gerstner, of theCancer Center at Massachusetts GeneralHospital, reported the latest follow-up results from the NABT 96-07 study: High doses of methotrexate are the most effective drugs for the treatment of primary central nervous system lymphoma (PCNSL), which provides long-term total remission (CR) in 20 percent of patients(Twittery 2008, 70 (5): 401)PCNSL is better developed in people aged 60 and over, and its routine treatment is all-brain radiotherapy, but all-brain radiotherapy is highly neurotoxicThe NABTT 96-07 study is a multicenter Phase II clinical trial in which 25 newly diagnosed adult PCNSL patients were enrolledThese patients received high doses of methotrexate-induced therapy (8 g/m2 intravenous lyve, every 2 weeks) until CR, the person receiving CR received another 2 courses of consolidation therapy (14 days for one course) and 11 courses of maintenance therapy (28 days for one course)Minimum follow-up 6.5 yearsIn 12 patients who received CR through methotrexate-induced treatment, 5 were followed up with a median time of 6.8 years and did not relapseA total of 14 patient deaths occurred, 11 of which were caused bydiseases
progression or cause of death unknown, 3 to otherdiseases
(2 died fromheartdisease, 1 died of septic arthritis), and no methotrexate-related deaths occurredA variety of life-saving treatments are used in relapsed patients Thirteen patients with relapses received radiotherapy, including 12 cases of whole-brain radiotherapy and 1 case of radiation surgery, of which 9 were fatal Six patients disease progressed beyond the central nervous system, three of which died of systemic progression The median progression-free survival was 12.8 months, the median disease-specific survival was 72.3 months, and the median total survival was 55.4 months, longer than the median total survival of individual whole-brain radiotherapy reported by previous studies (11.6 months) The researchers believe that methotrexate is a treatment that is no less effective than the existing standards
treatment but less toxic Currently, another prospective multicenter Phase II clinical trial is intended to involve about 40 PCNSL patients in the group to assess the effectiveness and safety of methotrexate and pyrozolamine, litoxiatimetin or topothycon in combination treatment of PCNSL, while also evaluating the return of cognitive function