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In the largest trial ever run in lymphoma of the brain, a stem cell transplant after MATRix chemotherapy kept 78 percent of patients free of progression at three years against 51 percent with conventional consolidation chemotherapy, and lengthened survival.
Randomised phase 3 trial in 368 patients aged 18 to 70 with newly diagnosed primary CNS lymphoma: after four cycles of MATRix, 230 patients with responding or stable disease were randomised to high-dose carmustine and thiotepa with autologous stem cell transplant or two cycles of R-DeVIC; 229 were analysed.
At a median follow-up of 45.3 months three-year progression-free survival was 78 percent after transplant against 51 percent after R-DeVIC (hazard ratio 0.43, p 0.0003), and overall survival was also improved. Adverse events per patient were 14.6 against 9.3; fatal serious adverse events after consolidation occurred in five transplant patients (infections, pulmonary embolism) and two R-DeVIC patients (acute myeloid leukaemia).
High-dose chemotherapy with autologous transplant is the preferred consolidation for fit patients with primary CNS lymphoma who complete MATRix induction.
Shares Carmustine, Thiotepa, Primary CNS lymphoma.
Shares MATRix/IELSG43, Carmustine, Thiotepa, Primary CNS lymphoma.
Shares Thiotepa, Primary CNS lymphoma.
Shares MATRix/IELSG43, Primary CNS lymphoma.
Shares Carmustine, Thiotepa, Primary CNS lymphoma.
Shares MATRix/IELSG43, Carmustine, Thiotepa, Primary CNS lymphoma.