Temodar and rituximab for primary CNS lymphoma – pro

The story of temazolomide for primary CNS lymphhoma starts in 2000, when the first case report ot its use was published. This patient with primary brain lymphoma who has been treated with temozolomide had a rapid and complete response, suggesting a potential therapeutic role for temozolomide. It was confirmed by several phase II studies, the latest in a 2007 study. A phase II trial showed a 26% objective responses and the drug was well tolerated without any major toxicity. A very small phase II trial of 7 patients was published in 2004 and used Tamodar and Rituxan. Although median survival was short, immunochemotherapy with rituximab and temozolomide was well tolerated and exhibited efficacy in this elderly and heavily pretreated cohort. The data obtained in the current study suggested the optimal induction dose of rituximab 375 mg/m2 on Day 1 and temozolomide 150 mg/m2 daily on Days 1-5. A 2004 paper in Neurology reported a small phase II study. Fifteen patients with a median age of 69 years had a 53% objective response rate with acceptable toxicity. Median overall survival is 14 months and median progression free survival of responding patients is 7.7 months.

Michele Reni , Andrés José María Ferreri , Claudio Landoni , and Eugenio Villa
Salvage Therapy With Temozolomide in an Immunocompetent Patient With Primary Brain Lymphoma J. Natl. Cancer Inst. 92: 575-576.

M.Reni, W.Mason, F.Zaja, J.Perry, E.Franceschi, D.Bernardi, S.Dell”Oro, C.Stelitano, M.Candela, A.Abbadessa, Salvage chemotherapy with temozolomide in primary CNS lymphomas: preliminary results of a phase II trial
European Journal of Cancer, Volume 40, Issue 11, Pages 1682-1688

Eric T. Wong et al, Immunochemotherapy with rituximab and temozolomide for central nervous system lymphomas Cancer Volume 101 Issue 1, Pages 139 – 145

Quinn J, Reardon D, Rich J, et al. Phase II treatment of adults with newly diagnosed, progressive, or recurrent primary central nervous system lymphoma with Temodar. Neuro-oncol 2003;5:354.

M Reni et al, Temozolomide as salvage treatment in primary brain lymphomas British Journal of Cancer (2007) 96, 864–867

Enting RH, Demopoulos A, DeAngelis LM, Abrey LE. Salvage therapy for primary CNS lymphoma with a combination of rituximab and temozolomide. Neurology 2004;63:901–3.

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