title: Temozolomide as salvage treatment in primary brain lymphomas.
abstract: Methotrexate (MTX)-based chemotherapy extends survival in patients with primary brain lymphomas, but it is not clear whether multiagent chemotherapy is superior to MTX alone. Treatment options for patients with recurrent primary brain lymphoma are limited; there is no standard second-line chemotherapy. New chemotherapeutic agents with clear activity in brain lymphoma are needed for treatment of recurrent disease. We report the results of a phase II trial assessing activity of the alkylating agent temozolomide in immunocompetent patients with recurrent primary brain lymphomas, previously treated with high-dose MTX-containing chemotherapy and/or radiotherapy. A median of two courses (range 1-12) of temozolomide 150 mg m-2 day-1, for 5 days every 4 weeks was administered to 36 patients yielding nine complete and two partial responses (response rate: 31%; 95% confidence interval 16-46%). One-year survival was 31% (95% confidence interval 16-46%). Toxicity was negligible. We conclude that temozolomide is active in recurrent primary brain lymphomas and should further be evaluated in this disease, perhaps in combination with MTX as initial treatment.
authors.affiliation: Medical Oncology Unit, Department of Oncology, San Raffaele Scientific Institute, Milan, Italy. reni.michele@hsr.it
authors.forename: M
authors.initials: M
authors.lastname: Reni
authors.forename: F
authors.initials: F
authors.lastname: Zaja
authors.forename: W
authors.initials: W
authors.lastname: Mason
authors.forename: J
authors.initials: J
authors.lastname: Perry
authors.forename: E
authors.initials: E
authors.lastname: Mazza
authors.forename: M
authors.initials: M
authors.lastname: Spina
authors.forename: R
authors.initials: R
authors.lastname: Bordonaro
authors.forename: F
authors.initials: F
authors.lastname: Ilariucci
authors.forename: M
authors.initials: M
authors.lastname: Faedi
authors.forename: G
authors.initials: G
authors.lastname: Corazzelli
authors.forename: P
authors.initials: P
authors.lastname: Manno
authors.forename: E
authors.initials: E
authors.lastname: Franceschi
authors.forename: A
authors.initials: A
authors.lastname: Pace
authors.forename: M
authors.initials: M
authors.lastname: Candela
authors.forename: A
authors.initials: A
authors.lastname: Abbadessa
authors.forename: C
authors.initials: C
authors.lastname: Stelitano
authors.forename: G
authors.initials: G
authors.lastname: Latte
authors.forename: A J M
authors.initials: AJ
authors.lastname: Ferreri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000009:adverse effects; D001932:Brain Neoplasms / Q000188:drug therapy*; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D016879:Salvage Therapy; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide