title: MATILDE chemotherapy regimen for primary CNS lymphoma: results at a median follow-up of 12 years.
abstract: OBJECTIVE
  We report updated results at a median follow-up of 12 years of a phase II trial assessing first-line MATILDE chemotherapy and response-tailored radiotherapy in patients with primary CNS lymphomas (PCNSL).
  
  
  METHODS
  Forty-one HIV-negative patients (18-70 years; Eastern Cooperative Oncology Group performance status ≤3) with histologically confirmed PCNSL received 3 courses of MATILDE chemotherapy followed by whole-brain radiotherapy (WBRT). Chemotherapy activity was the primary endpoint.
  
  
  RESULTS
  Overall response rate was 76% (95% confidence interval [CI] 63%-89%) after chemotherapy and 83% (95% CI 71%-95%) after chemotherapy ± radiotherapy. At a median follow-up of 144 months (range 47-153), 31 patients experienced an event: relapse in 24, progressive disease in 3, and toxic death in 4, with a 5-year progression-free survival of 24% ± 8%. Two patients experienced a late relapse (100 and 101 months). Nine patients are alive and disease-free, 8 of whom are alive at >10 years, with a 5-year overall survival of 30% ± 7%. At 10 years from diagnosis, no patient showed chronic hematologic and nonhematologic toxicities, with a Mini-Mental State Examination score of ≥29 in all cases but one.
  
  
  CONCLUSIONS
  At a median follow-up of 12 years, MATILDE regimen followed by WBRT confirmed the previously reported survival plateau, which further proves its long-lasting efficacy with acceptable neurologic deficits.
  
  
  METHODS
  This study provides Class IV evidence that in patients with PCNSL, MATILDE chemotherapy followed by response-tailored radiotherapy increases the probability of disease remission at 12 years.
authors.affiliation: From the Unit of Lymphoid Malignancies (A.J.M.F.), UTMO & Hematology Unit, Department of Onco-Hematology (F.C.), and Medical Oncology Unit, Department of Oncology (M.R.), San Raffaele Scientific Institute, Milan; Department of Medical Oncology (A.A.B.), Bellaria-Maggiore Hospital, Azienda Unità Sanitaria Locale, Bologna; Division of Hematology (M.M.), Ospedale di Ancona; Department of Medical Oncology and Hematology (M.B.), Istituto Clinico Humanitas, Rozzano; Division of Medical Oncology A (M.S.), National Cancer Institute, Aviano; Division of Hematology (F.I.), Ospedale di Reggio Emilia; Division of Hematology (F.Z.), Ospedale di Udine; Division of Hematology (C.S.), Ospedale di Reggio Calabria; Division of Hematology (F.B.), Ospedale Maggiore di Novara; Division of Hematology (G.C.), Istituto Nazionale dei Tumori Pascale di Napoli; and the Division of Hematology (L.B.), Ospedale Maggiore di Milano, Italy.
authors.forename: Andrés J M
authors.initials: AJ
authors.lastname: Ferreri
authors.forename: Fabio
authors.initials: F
authors.lastname: Ciceri
authors.forename: Alba A
authors.initials: AA
authors.lastname: Brandes
authors.forename: Mauro
authors.initials: M
authors.lastname: Montanari
authors.forename: Monica
authors.initials: M
authors.lastname: Balzarotti
authors.forename: Michele
authors.initials: M
authors.lastname: Spina
authors.forename: Fiorella
authors.initials: F
authors.lastname: Ilariucci
authors.forename: Francesco
authors.initials: F
authors.lastname: Zaja
authors.forename: Caterina
authors.initials: C
authors.lastname: Stelitano
authors.forename: Flavio
authors.initials: F
authors.lastname: Bobbio
authors.forename: Gaetano
authors.initials: G
authors.lastname: Corazzelli
authors.forename: Luca
authors.initials: L
authors.lastname: Baldini
authors.forename: Michele
authors.initials: M
authors.lastname: Reni
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage / Q000627:therapeutic use; D008223:Lymphoma / Q000188:drug therapy* / Q000532:radiotherapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D012074:Remission Induction; D013852:Thiotepa / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D013852:Thiotepa; D008727:Methotrexate; D015255:Idarubicin