Abstract Types

CRA
Clinical Review Abstract

LBA
Late-Breaking Abstract

TPS
Trials in Progress Abstract

e
Abstracts selected for publication but not presentation at the Annual Meeting

^
Abstracts granted an exception in accordance with ASCO's Conflict of Interest Policy



Preirradiation chemotherapy with methotrexate, rituximab, and temozolomide and post-irradiation temozolomide for primary central nervous system lymphoma: RTOG 0227 phase II study results.

Sub-category:
CNS Tumors

Category:
Central Nervous System Tumors

Meeting:
2013 ASCO Annual Meeting

Abstract No:
2033

Citation:
J Clin Oncol 31, 2013 (suppl; abstr 2033)

Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2013 Annual Meeting but not presented at the Meeting, can be found online only.

Author(s): Jon Glass, Minhee Won, Christopher J. Schultz, Daniel Brat, Nancy Bartlett, John H. Suh, Barbara Jean Fisher, Marcia K. Liepman, Minesh P. Mehta; Thomas Jefferson University, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; Medical College of Wisconsin, Milwaukee, WI; Emory University, Atlanta, GA; Washington University School of Medicine in St. Louis; Siteman Cancer Center, St. Louis, MO; Cleveland Clinic, Cleveland, OH; Department of Radiation Oncology, London Regional Cancer Program, London, ON, Canada; West Michigan Cancer Center, Kalamazoo, MI; University of Maryland, Baltimore, MD

Abstract Disclosures


Abstract:

Background: This prospective phase II study tested a methotrexate (MTX), temozolomide (TMZ) and rituximab (RTX) pre-irradiation regimen with hyperfractionated whole brain radiation therapy (hWBRT) followed by post-irradiation TMZ for patients with primary CNS lymphoma (PCNSL). The primary phase II endpoint was the 2-year overall survival (OS) rate compared with the 2-year OS from RTOG 93-10 (MTX, procarbazine, vincristine, whole brain radiation therapy, cytarabine). Secondary endpoints were pre-irradiation chemotherapy tumor response rates (compared to RTOG 93-10), progression free survival (PFS), acute and late neurologic toxicities, and quality of life. Methods: 53 patients (28 women, 25 men), median age 57.5 years, median Zubrod 1 were treated with RTX 375 mg/m2 3 days prior to first cycle of MTX; 5 cycles of intravenous MTX 3.5 g/m2 with leucovorin rescue on weeks 1, 3, 5, 7, 9; TMZ 100 mg/m2 daily for 5 days weeks 4 and 8; hWBRT 1.2 Gy twice daily fractions 5 days/week on weeks 11, 12, 13 for a total of 36 Gy and TMZ 200 mg/m2 daily for 5 days on weeks 14, 18, 22, 26, 30, 34, 38, 42, 46, 50. Results: Dosing of pre-irradiation temozolomide at 100 mg/m2 was determined in the phase I portion of the study. With a median follow-up of 3.6 years, 2-year OS and PFS rates were 80.8% and 63.6%, respectively. Compared with historical controls from RTOG 93-10, 2-year OS and PFS were significantly improved (p = 0.006 and 0.03). The overall response rate to the pre-irradiation chemotherapy was 37.7% (complete response 11.3%, partial response 26.4%). 38% experienced grade 3 and 25% experienced grade 4 toxicities before the start of hWBRT. 33% experienced grade 3 and 21% experienced grade 4 toxicities attributable to post-hWBRT chemotherapy. Conclusions: The combination of MTX, TMZ, RTX followed by hWBRT and TMZ for PCNSL is safe with demonstrated improved 2 year OS and PFS compared with RTOG 93-10. Further investigations regarding the role of hWBRT and post-hWBRT TMZ are indicated. This project was supported by RTOG grant U10 CA21661 and CCOP grant U10 CA37422 from the National Cancer Institute (NCI) and Schering-Plough. Clinical trial information: NCT00068250.

 

  Other Abstracts in this Sub-Category:

 

1. RTOG 0825: Phase III double-blind placebo-controlled trial evaluating bevacizumab (Bev) in patients (Pts) with newly diagnosed glioblastoma (GBM).

Meeting: 2013 ASCO Annual Meeting Abstract No: 1 First Author: M. R. Gilbert
Category: Central Nervous System Tumors - CNS Tumors

 

2. Bevacizumab, irinotecan, and radiotherapy versus standard temozolomide and radiotherapy in newly diagnosed, MGMT-nonmethylated glioblastoma patients: First results from the randomized multicenter GLARIUS trial.

Meeting: 2013 ASCO Annual Meeting Abstract No: LBA2000 First Author: U. Herrlinger
Category: Central Nervous System Tumors - CNS Tumors

 

3. A randomized phase II study of bevacizumab versus bevacizumab plus lomustine versus lomustine single agent in recurrent glioblastoma: The Dutch BELOB study.

Meeting: 2013 ASCO Annual Meeting Abstract No: 2001 First Author: W. Taal
Category: Central Nervous System Tumors - CNS Tumors

 

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