Rituxa reg; plus Temodar® Effective for Primary Central Nervous System Lymphoma

Researchers from Italy have reported that the combination of Rituxan (rituximab) and Temodar (temozolomide) is an effective treatment regimen for patients with primary central nervous system non-Hodgkin’s lymphoma (NHL). This phase II study was presented at the 2005 meeting of the American Society of Clinical Oncology in Orlando, Florida, May 13-17 2005.

Primary central nervous system lymphoma is a relatively uncommon form of (NHL) that has been increasing in incidence over the past three decades. Unlike the progre made in the general treatment of NHL, there has been little progre in the treatment of primary central nervous system NHL. The standard treatment is high-dose methotrexate and whole-brain radiotherapy which has improved outcomes. However, treatment-related neurotoxicity is common, e ecially in the elderly who often have poor renal function. At the present time there is no optimal treatment of elderly patients with primary central nervous system NHL. Temodar is an alkylating agent used to treat primary and secondary brain tumors, e ecially glioblastoma multiforme. It is administered orally and is reasonably well tolerated.

The current study evaluated 10 elderly patients with primary central nervous system NHL who did not have HIV or other immune su re ive disease. All were 60 years of age or older and all were said to have poor renal function. Rituxan was given on day 1 and Temodar orally on days 1-5 with cycles repeated every 28 days. After four cycles of therapy there were four complete and two partial re o es and one partial re o e was converted to a complete re o e after two more cycles of therapy. Thus, half the patients had a complete re o e to therapy. The average duration of re o e was seven months and the average survival was 10 months. Grade 3 neutropenia and thrombocytopenia was o erved in three patients. These authors concluded that this was a well tolerated and highly active regimen for patients with primary central nervous system NHL.

Comments: Primary central nervous system NHL is a rare disease but treatment is u atisfactory and this regimen offers a relatively non-toxic a roach to palliation.

Reference: adaro P, Pitini V, Arrigo C. et al. Immunochemotherapy with temozolomide and rituximab for central nervous system lymphomas in the elderly populatio . Proceedings from the a ual meeting of the American Society of Clinical Oncology. Orlando FL. 2005; A tract #6673.