title: Pemetrexed plus rituximab as second-line treatment for primary central nervous system lymphoma.
abstract: The aim of the study was to determine the efficacy and toxicity of pemetrexed plus rituximab in patients with primary central nervous system lymphoma, who had undergone treatment with high-dose (HD) methotrexate-based regimens. Patients who had failed HD methotrexate-based regimens treatment had ECOG performance status ranging from 0 to 2. Twenty-seven patients received pemetrexed plus rituximab as second-line treatment. Rituximab 375 mg/m(2) was administered on day 0 and pemetrexed 500 mg/m(2) was administered on day 1 every 3 weeks. Six patients (22.2 %) experienced CR, 11 patients (40.7 %) had PR, eight patients (29.6 %) had SD, and two patients had PD. The response rate was 62.9 %. The median time to progression (PFS) was 6.9 months (95 % CI, 5.6-8.3), and the median overall survival was 11.2 months (95 % CI, 9.1-13.4). In the subgroup analysis, PFS had a significant difference among the low level of serum miR-21 and high level of serum miR-21. PFS was 9.0 (95 % CI, 6.3-11.6) and 5.7 months (95 % CI, 4.6-6.9, log rank = 0.015), respectively. None of the patient experienced grade 4 toxicity. A regimen of pemetrexed combined with rituximab is marginally effective and well tolerated in patients with PCNSL who had failed HD methotrexate-based regimens first-line treatment.
authors.affiliation: Department of Neurosurgery, Shan Dong Tumor Hospital, No. 440, Jiyan Jinan Road, Jinan, Shandong, 250117, People's Republic of China.
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Zhao
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Sheng-Bin
authors.initials: SB
authors.lastname: Shi
authors.forename: Jing
authors.initials: J
authors.lastname: Tian
authors.forename: Rong-Jie
authors.initials: RJ
authors.lastname: Tao
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed / Q000008:administration & dosage / Q000009:adverse effects; D000069283:Rituximab / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000068437:Pemetrexed; D000069283:Rituximab