Efficacy of individualized orelabrutinib-based regimens in relapsed or refractory central nervous system lymphoma
BackgroundRelapsed or refractory central nervous system lymphoma (rrCNSL) lacks established preferred treatment and carries an inferior prognosis. Bruton’s tyrosine kinase inhibitor (BTKi) showed promising effectiveness. Orelabrutinib is a second-generation BTKi with a high concentration in cerebros...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1570224/full |
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| author | Yuchen Wu Xuefei Sun Liwei Lv Qu Cui Jun Qian Ruixian Xing Xueyan Bai Yuedan Chen Qing Liu Wenyuan Lai Chunji Gao Shengjun Sun Nan Ji Yuanbo Liu |
| author_facet | Yuchen Wu Xuefei Sun Liwei Lv Qu Cui Jun Qian Ruixian Xing Xueyan Bai Yuedan Chen Qing Liu Wenyuan Lai Chunji Gao Shengjun Sun Nan Ji Yuanbo Liu |
| author_sort | Yuchen Wu |
| collection | DOAJ |
| description | BackgroundRelapsed or refractory central nervous system lymphoma (rrCNSL) lacks established preferred treatment and carries an inferior prognosis. Bruton’s tyrosine kinase inhibitor (BTKi) showed promising effectiveness. Orelabrutinib is a second-generation BTKi with a high concentration in cerebrospinal fluid.MethodsIn this retrospective analysis, the outcomes of 37 relapsed or refractory central nervous system diffuse large B-cell lymphoma patients who received orelabrutinib, high-dose methotrexate, ifosfamide, etoposide, and dexamethasone (Ore-MIED) or orelabrutinib, high-dose methotrexate, temozolomide and dexamethasone (Ore-MTD) were evaluated.ResultsOf the 37 patients included, 11 received Ore-MTD, and 26 received the Ore-MIED regimen. The overall response rate in our cohort was 89.2%, with complete remission achieved in 51.4% of patients and partial remission in 37.8% of patients. The median progression-free survival was observed to be 7.0 months. No statistically significant difference was found in the median progression-free survival between patients receiving different treatment regimens (5.0 months for Ore-MTD versus 13.0 months for Ore-MIED; p = 0.29). Moreover, the median overall survival has not been reached in this cohort, indicating a promising outcome despite the aggressive nature of the disease.ConclusionOur study confirms the effectiveness and safety of Ore-MIED/Ore-MTD in rrCNSL patients, even in those with previous exposure to multiple lines of treatment. |
| format | Article |
| id | doaj-art-477ae0e4fc0144a3b2c0c9abe5ec0d63 |
| institution | DOAJ |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-477ae0e4fc0144a3b2c0c9abe5ec0d632025-08-20T03:07:44ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.15702241570224Efficacy of individualized orelabrutinib-based regimens in relapsed or refractory central nervous system lymphomaYuchen Wu0Xuefei Sun1Liwei Lv2Qu Cui3Jun Qian4Ruixian Xing5Xueyan Bai6Yuedan Chen7Qing Liu8Wenyuan Lai9Chunji Gao10Shengjun Sun11Nan Ji12Yuanbo Liu13Department of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Chinese PLA General Hospital, Beijing, ChinaNeuroimaging Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaBackgroundRelapsed or refractory central nervous system lymphoma (rrCNSL) lacks established preferred treatment and carries an inferior prognosis. Bruton’s tyrosine kinase inhibitor (BTKi) showed promising effectiveness. Orelabrutinib is a second-generation BTKi with a high concentration in cerebrospinal fluid.MethodsIn this retrospective analysis, the outcomes of 37 relapsed or refractory central nervous system diffuse large B-cell lymphoma patients who received orelabrutinib, high-dose methotrexate, ifosfamide, etoposide, and dexamethasone (Ore-MIED) or orelabrutinib, high-dose methotrexate, temozolomide and dexamethasone (Ore-MTD) were evaluated.ResultsOf the 37 patients included, 11 received Ore-MTD, and 26 received the Ore-MIED regimen. The overall response rate in our cohort was 89.2%, with complete remission achieved in 51.4% of patients and partial remission in 37.8% of patients. The median progression-free survival was observed to be 7.0 months. No statistically significant difference was found in the median progression-free survival between patients receiving different treatment regimens (5.0 months for Ore-MTD versus 13.0 months for Ore-MIED; p = 0.29). Moreover, the median overall survival has not been reached in this cohort, indicating a promising outcome despite the aggressive nature of the disease.ConclusionOur study confirms the effectiveness and safety of Ore-MIED/Ore-MTD in rrCNSL patients, even in those with previous exposure to multiple lines of treatment.https://www.frontiersin.org/articles/10.3389/fneur.2025.1570224/fullcentral nervous system lymphomarelapsed or refractoryBruton’s tyrosine kinase inhibitororelabrutinibmethotrexate |
| spellingShingle | Yuchen Wu Xuefei Sun Liwei Lv Qu Cui Jun Qian Ruixian Xing Xueyan Bai Yuedan Chen Qing Liu Wenyuan Lai Chunji Gao Shengjun Sun Nan Ji Yuanbo Liu Efficacy of individualized orelabrutinib-based regimens in relapsed or refractory central nervous system lymphoma Frontiers in Neurology central nervous system lymphoma relapsed or refractory Bruton’s tyrosine kinase inhibitor orelabrutinib methotrexate |
| title | Efficacy of individualized orelabrutinib-based regimens in relapsed or refractory central nervous system lymphoma |
| title_full | Efficacy of individualized orelabrutinib-based regimens in relapsed or refractory central nervous system lymphoma |
| title_fullStr | Efficacy of individualized orelabrutinib-based regimens in relapsed or refractory central nervous system lymphoma |
| title_full_unstemmed | Efficacy of individualized orelabrutinib-based regimens in relapsed or refractory central nervous system lymphoma |
| title_short | Efficacy of individualized orelabrutinib-based regimens in relapsed or refractory central nervous system lymphoma |
| title_sort | efficacy of individualized orelabrutinib based regimens in relapsed or refractory central nervous system lymphoma |
| topic | central nervous system lymphoma relapsed or refractory Bruton’s tyrosine kinase inhibitor orelabrutinib methotrexate |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1570224/full |
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