Rituximab, Methotrexate, Carmustine, Etoposide, and Prednisone (RMBVP) for the treatment of relapsed/refractory primary central nervous system lymphoma: a retrospective single-center study

Abstract

Relapsed/refractory Primary Central Nervous System Lymphoma (R/R PCNSL) has a poor prognosis with no established preferred treatment. We report the efficacy and toxicity of a combination chemotherapy regimen: methotrexate, carmustine, etoposide, and prednisone with or without rituximab (RMBVP). This retrospective study included thirty patients who received a median of two 28-day cycles (0.5–5). The median age was 66 years (23–81); median KPS was 70 (30–90); 14 (46.7%) were women. Patients received a median of 2 prior lines of therapy and all received prior methotrexate. Of 29 evaluable patients, the overall response rate was 73.3% (n = 22). Median progression-free survival (PFS) was 15.6 months. Patients who recurred or progressed <12 months since last chemotherapy had a shorter median PFS (7.6 vs 37.6 months). Toxicity was moderate with 20% rates of severe myelosuppression. RMBVP is a tolerable treatment option for R/R PCNSL, with favorable response rates in those with recurrent disease.

Keywords:

• Lymphoma and Hodgkin disease
• pharmacotherapeutics
• chemotherapeutic approaches

Disclosure statement

The views expressed in this article are our own and not an official position of our institutions. CG: consultation fees from ONO, BTG, and Kite. PY: at the time of manuscript submission, PY is now an employee of Flatiron Health, an independent subsidiary of the Roche Group, and holds stock in Roche.

Additional information

Funding

This research was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748. CG was supported by grants from Cycle for Survival Equinox and the Leukemia & Lymphoma Society.