Long-term survival in primary CNS lymphoma treated by high-dose methotrexate monochemotherapy: role of STAT6 activation as prognostic determinant.
We report a single-center experience of 16 immunocompetent patients diagnosed with primary central nervous system lymphoma and treated with monochemotherapy with high-dose methotrexate (MTX) and deferred radiotherapy. MTX was given at a dose of 8.0 g/m2 for induction and at a dose of 3.5-8.0 g/m2 for maintenance. There were eight complete responses (CR), one partial response, one stable disease, and six patients whose tumors progressed in spite of the chemotherapy. At final follow-up, five of five CRs were alive and well without radiotherapy, with median follow-up of 26 months. Overall survival in eight non-CRs treated with the subsequent radiotherapy was 36 months. In the immunohistochemical study, STAT6 was positively expressed in 8 out of 13 cases. They included all non-CRs and two CRs. This observation suggests that STAT6 expression can be used as a prognostic determinant for MTX chemotherapy.
Yang
Seung-Ho
SH
Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea.
Lee
Kun Soo
KS
Kim
Il Sup
IS
Hong
Jae Taek
JT
Sung
Jae Hoon
JH
Son
Byung Chul
BC
Lee
Sang Won
SW
Hong
Yong-Kil
YK
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D014408:Biomarkers, Tumor / Q000032:analysis; D016543:Central Nervous System Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D011379:Prognosis; D050800:STAT6 Transcription Factor / Q000378:metabolism*
D000964:Antimetabolites, Antineoplastic; D014408:Biomarkers, Tumor; D050800:STAT6 Transcription Factor; C494101:STAT6 protein, human; D008727:Methotrexate