Maintenance chemotherapy does not extend survival in CNS lymphoma
Researchers at IGP have shown that maintenance chemotherapy with temozolomide does not result in an extended survival in patients with CNS lymphoma. The findings suggest that current treatment practice should be evaluated.
Lymphoma is a cancer from lymphocytes that comes in many forms and can arise in different parts of the body. Lymphoma in the central nervous system (CNS) is a rare but aggressive type, which is usually treated with chemotherapy and in some cases with stem cell transplantation. Although many patients respond well to initial treatment, relapse remains a major clinical challenge.
Current international guidelines support the use of temozolomide maintenance treatment in selected patients with CNS lymphoma. However, the clinical benefit of this approach has still not been clearly demonstrated.
In the current study, the researchers analysed disease outcomes from 110 Swedish patients to investigate whether temozolomide maintenance therapy improves overall survival.
“Initially, patients receiving maintenance therapy appeared to have better outcomes. However, this advantage disappeared after adjusting for treatment timing and other important clinical factors. Instead, survival was primarily associated with established prognostic factors, such as younger age and successful completion of intensive treatment,” says Mats Hellström, adjunct senior lecturer at IGP, who led the study.
The researchers’ conclusion is that their findings underscore the importance of critically evaluating current practice and highlight the need for prospective clinical trials to better define the role of maintenance treatment in this disease.
The study was performed in collaboration with researchers at Karolinska Institutet and Lund University. It has been published in the scientific journal Hemasphere.