Efficacy and safety of pemetrexed on recurrent primary central nervous system lymphomas in China: a prospective study

• Main Authors: Sun Y, Wang Y, Han S, Xing B, Li H, Zhu Y, Zhou S, Wang X, Xu J, Tao R
• Format: Article
• Language: English
• Published: Dove Medical Press 2017-05-01
• Series: OncoTargets and Therapy
• Subjects: primary central nervous system lymphomas; efficacy; safety; recurrence
• Online Access: https://www.dovepress.com/efficacy-and-safety-of-pemetrexed-on-recurrent-primary-central-nervous-peer-reviewed-article-OTT

Yi Sun,1–3,* Yong Wang,2,* Shaolong Han,3 Bo Xing,3 Hong Li,4 Yufang Zhu,2 Shizhen Zhou,2 Xiuhua Wang,2 Jun Xu,2 Rongjie Tao2 1School of Medicine and Life Sciences, University of Jinan, Shandong Academy of Medical Sciences, 2Department of Neurosurgery, Shandong Cancer Hospital affiliated to Shandong University, 3Department of Neurosurgery, The Sixth People’s Hospital of Jinan, 4Department of Ophthalmology and Otolaryngology, The Sixth People’s Hospital of Jinan, Jinan City, Shandong Province, People’s Republic of China *These authors contributed equally to this work Background: Pemetrexed, a new and novel agent for primary central nervous system lymphomas (PCNSLs), has shown to be efficient as a savage therapy for recurrent PCNSLs. However, more studies are needed. A prospective study was performed on 17 recurrent PCNSL patients with pemetrexed at Shandong Tumor Hospital in China to assess the efficacy and safety of pemetrexed for recurrent PCNSL patients. Materials and methods: The medical records and imaging data on all the cases of recurrent PCNSL patients with pemetrexed in our study were collected during August 2012 and April 2015. Folic acid, B12, and dexamethasone were used to induce toxicities related to pemetrexed. Patients were treated with pemetrexed at a dose of 900 mg/m2 intravenously every 3 weeks, and one cycle consists of 6 weeks. Results: A total of 17 cases of recurrent PCNSL patients were enrolled in our study, including 10 males and 7 females with a median age of 66.2 years (ranging from 35 to 81). After the treatment, five cases had complete remission, with partial remission in five cases, stable disease in four cases, and progressive disease in three cases. Consequently, the overall response rate was 58.8%, and the disease control rate was 82.4%. The median overall survival was 7.8 months (95% confidence interval: 5.9–9.6 months) in the study of recurrent PCNSL patients. Conclusion: This study has been the first clinical trial that applied pemetrexed to treat recurrent PCNSL patients in China, and results indicated that chemotherapy using large pemetrexed may become an effective treatment for PCNSL recurrence with modest toxicity. Keywords: primary central nervous system lymphomas, efficacy, safety, recurrence