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Editorials
and the prevention and treatment of CNS relapse remains an unmet clinical need in the management of DLBCL. Penetrating the blood-brain barrier is an important con- sideration, but improved therapies will be required to overcome intrinsic chemotherapy resistance. A nuanced mechanistic understanding of targetable pathways under- pinning DLBCL involving the CNS has led to novel tar- geted agents and immunotherapy approaches that demonstrate promising clinical activity and good CNS penetrance. Novel agents that target oncogenic drivers based on the underlying biology of DLBCL subtypes may ultimately prove to be the most effective way to prevent and/or treat CNS recurrence.
Disclosures
No conflicts of interest to disclose.
References
1. Bobillo S, Younes A. Central nervous system prophylaxis with high- dose methotrexate or intrathecal chemotherapy in diffuse large B- cell lymphoma and high-risk of CNS relapse. Haematologica. 2020; 106(2):513-521.
2. Eyre TA, Kirkwood AA, Wolf J, et al. Stand-alone intrathecal central nervous system (CNS) prophylaxis provide unclear benefit in reduc- ing CNS relapse risk in elderly DLBCL patients treated with R- CHOP and is associated increased infection-related toxicity. Br J Haematol. 2019;187(2):185-194.
3. Schmitz R, Wright GW, Huang DW, et al. Genetics and pathogenesis of diffuse large B-cell lymphoma. N Engl J Med. 2018;378(15):1396- 1407.
4. Chapuy B, Stewart C, Dunford AJ, et al. Molecular subtypes of dif- fuse large B cell lymphoma are associated with distinct pathogenic mechanisms and outcomes. Nat Med. 2018;24(5):679-690.
5. Wright GW, Huang DW, Phelan JD, et al. A probabilistic classifica- tion tool for genetic subtypes of diffuse large B cell lymphoma with therapeutic implications. Cancer Cell. 2020;37(4):551-568.
6. Schmitz N, Zeynalova S, Nickelsen M, et al. CNS international prog- nostic index: a risk model for CNS relapse in patients with diffuse large B-cell lymphoma treated with R-CHOP. J Clin Oncol. 2016;34(26):3150-3156.
7. Klanova M, Sehn LH, Bence-Bruckler I, et al. Integration of cell of ori- gin into the clinical CNS International Prognostic Index improves CNS relapse prediction in DLBCL. Blood. 2019;133(9):919-926.
8.Arvanitis CD, Ferraro GB, Jain RK. The blood-brain barrier and blood-tumour barrier in brain tumours and metastases. Nat Rev Cancer. 2020;20(1):26-41.
9. Eyre TA, Djebbari F, Kirkwood AA, Collins GP. Efficacy of central nervous system prophylaxis with stand-alone intrathecal chemotherapy in diffuse large B-cell lymphoma patients treated with anthracycline-based chemotherapy in the rituximab era: a sys- tematic review. Haematologica. 2020;105(7):1914-1924.
10. Abramson JS, Hellmann M, Barnes JA, et al. Intravenous methotrex- ate as central nervous system (CNS) prophylaxis is associated with a low risk of CNS recurrence in high-risk patients with diffuse large B- cell lymphoma. Cancer. 2010;116(18):4283-4290.
11. McKay P, Wilson MR, Chaganti S, et al. The prevention of central nervous system relapse in diffuse large B-cell lymphoma: a British Society for Haematology good practice paper. Br J Haematol. 2020;190(5):708-714.
12. Ambady P, Holdhoff M, Bonekamp D, Wong F, Grossman SA. Late relapses in primary CNS lymphoma after complete remissions with high-dose methotrexate monotherapy. CNS Oncol. 2015;4(6):393-398.
13. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375-2390.
14. Ollila TA, Kurt H, Waroich J, et al. Genomic subtypes may predict the risk of central nervous system recurrence in diffuse large B-cell lymphoma. Blood. 2020 Sep 2. [Epub ahead of print]
15.Twa DDW, Lee DG, Tan KL, et al. Genomic predictors of central nervous system relapse in primary testicular diffuse large B-cell lym- phoma (DLBCL). Blood. 2020 Sep 23. [Epub ahead of print]
16. Lionakis MS, Dunleavy K, Roschewski M, et al. Inhibition of B cell receptor signaling by ibrutinib in primary CNS lymphoma. Cancer Cell. 2017;31(6):833-843.e5.
17. Grommes C, Pastore A, Palaskas N, et al. Ibrutinib unmasks critical role of bruton tyrosine kinase in primary CNS lymphoma. Cancer Discov. 2017;7(9):1018-1029.
18. Younes A, Sehn LH, Johnson P, et al. Randomized phase III trial of ibrutinib and rituximab plus cyclophosphamide, doxorubicin, vin- cristine, and prednisone in non-germinal center B-cell diffuse large B- cell lymphoma. J Clin Oncol. 2019;37(15):1285-1295.
19. Ghesquieres H, Chevrier M, Laadhari M, et al. Lenalidomide in com- bination with intravenous rituximab (REVRI) in relapsed/refractory primary CNS lymphoma or primary intraocular lymphoma: a multi- center prospective 'proof of concept' phase II study of the French Oculo-Cerebral lymphoma (LOC) Network and the Lymphoma Study Association (LYSA). Ann Oncol. 2019;30(4):621-628.
20. Nowakowski GS, Hong F, Scott DW, et al. Addition of Lenalidomide to R-CHOP (R2CHOP) improves outcomes in newly diagnosed dif- fuse large B-Cell lymphoma (DLBCL): first report of ECOG- ACRIN1412 a randomized phase 2 US intergroup study of R2CHOP vs R-CHOP. Hematol Oncol. 2019;37(S2):37-8.
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