Secondary central nervous system lymphoma (SCNSL) occurred in about 5% of patients with diffuse large B-cell lymphoma (DLBCL). The prognosis of SCNSL is very poor. A number of retrospective studies have shown that the median overall survival (mOS) since the diagnosis of CNSL is only 2.5-3.5 months, and the 2-year OS rate is only 20%. At present, there is no consensus on the treatment of SCNSL, and new therapeutic strategies are urgently needed. Zanubrutinib is a new second-generation BTK inhibitor, which has showed good efficacy and safety in a variety of B-NHL. Zanubrutinib has showed good blood-brain barrier permeability in preclinical studies. This study attempts to evaluate the efficacy and safety of zanubrutinib combined with rituximab and high-dose methotrexate in the treatment of SCNSL in patients with DLBCL.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
45
Induction therapy: Zanubrutinib will be given as 160mg bid orally between days 1 and 14 of each 14-day cycle; rituximab will be given at 375mg/m2 intravenously on day 1 of each cycle; methotrexate at 3.5g/m2 for patients ≤65 or 1.5g/m2 for patients \>65 (standard hydration/leucovorin support) will be given intravenously on day 2 of each 14-day cycle; for 6 cycles. Consolidation therapy: For patients ≤65, autologous hematopoietic stem cell transplantation (ASCT with a conditioning regimen of thiotepa/carmustine) will be given as consolidation treatment after induction therapy. Maintenance therapy:Drug: zanubrutinib. Zanubrutinib will be given as 160mg bid orally continuously until progression of the disease (PD), intolerable toxicity, death, or patient/investigator discretion.
Peking University Cancer Hospital & Institute
Beijing, Beijing Municipality, China
RECRUITINGprogression free survival
Progression-free survival (PFS) is defined as the time from the date of treatment start to the date of the first documented PD or death due to any cause
Time frame: 1-year
Overall response rate (ORR)
Time frame: at the end of 6 cycles of induction therapy (each cycle is 14 days)
Complete response (CR)
Time frame: at the end of 6 cycles of induction therapy
Partial response (PR)
Time frame: at the end of 6 cycles of induction therapy (each cycle is 14 days)
Overall survival (OS)
Time frame: 1-year
safety/tolerability by assessing the frequency and severity of adverse events
Time frame: at the end of 6 cycles of induction therapy (each cycle is 14 days), 1 year and 2 year maintenance therapy
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.