TY - JOUR T1 - Fotemustine-based therapy in combination with rituximab as a first-line induction chemotherapy followed by WBRT for newly diagnosed primary central nervous system lymphoma: a prospective phase II trial JF - Cancer Biology & Medicine JO - Cancer Biology & Medicine SP - 1089 LP - 1099 DO - 10.20892/j.issn.2095-3941.2021.0026 VL - 19 IS - 7 AU - Jingjing Wu AU - Fenghua Gao AU - Wenhua Wang AU - Xudong Zhang AU - Meng Dong AU - Lei Zhang AU - Xin Li AU - Ling Li AU - Zhenchang Sun AU - Xinhua Wang AU - Xiaorui Fu AU - Linan Zhu AU - Mengjie Ding AU - Songtao Niu AU - Zhaoming Li AU - Yu Chang AU - Feifei Nan AU - Jiaqian Yan AU - Hui Yu AU - Xiaolong Wu AU - Zhiyuan Zhou AU - Jieming Zhang AU - Mingzhi Zhang Y1 - 2022/07/15 UR - http://www.cancerbiomed.org/content/19/7/1089.abstract N2 - Objective: This study aimed to evaluate the safety, efficacy, and feasibility of the rituximab, fotemustine, pemetrexed, and dexamethasone (R-FPD) regimen followed by whole-brain radiotherapy (WBRT) for patients with primary central nervous system lymphoma (PCNSL).Methods: A prospective, single-center phase II clinical trial was conducted. Patients with PCNSL newly diagnosed at the First Affiliated Hospital of Zhengzhou University between July 2018 and July 2020 were studied. The R-FPD regimen consisted of rituximab (375 mg/m2 i.v. on D0), fotemustine (100 mg/m2 i.v. on D1), pemetrexed (600 mg/m2 i.v. on D1), and dexamethasone (40 mg i.v. on D1-5). Patients 60 years or younger who showed a complete response (CR) were treated with 23.4 Gy of WBRT after the end of chemotherapy; those older than 60 years with CR were treated with a wait-and-see approach; and those who did not show CR after the 4th cycle of chemotherapy were given salvage WBRT 30 Gy + local tumor field irradiation up to 45 Gy, regardless of age.Results: A total of 30 patients were included. After 2 cycles, the objective response rate (ORR) was 96.5% (28/29, 1 CR, 27 PR, 0 SD, and 1 PD). After 4 cycles, the ORR was 73.1% (19/26, 11 CR, 8 PR, 4 SD, and 3 PD). After WBRT, the ORR was 90.9% (10/11, 7 CR, 3 PR, and 1 SD). The grade III and IV toxicity responses were mainly leukopenia (20.0%), thrombocytopenia (23.3%), and anemia (10.0%).Conclusions: Fotemustine-based therapy in combination with rituximab chemotherapy followed by WBRT can improve outcomes, providing ORR benefits and favorable tolerability in patients newly diagnosed with PCNSL. ER -