Efficacy and safety of ibrutinib in central nervous system lymphoma: A systematic review and meta-analysis
<h3>Background</h3><p dir="ltr"><u>Primary central nervous system lymphoma</u> (CNSL) is a rare, aggressive non-Hodgkin lymphoma confined to the CNS. Although radiation and chemotherapy, particularly high-dose <u>methotrexate</u> (HD-MTX), are effe...
محفوظ في:
| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , , , , , |
| منشور في: |
2024
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| الموضوعات: | |
| الوسوم: |
إضافة وسم
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| الملخص: | <h3>Background</h3><p dir="ltr"><u>Primary central nervous system lymphoma</u> (CNSL) is a rare, aggressive non-Hodgkin lymphoma confined to the CNS. Although radiation and chemotherapy, particularly high-dose <u>methotrexate</u> (HD-MTX), are effective treatments, the relapse rates remain high, prompting the exploration of novel therapeutic options.<u> Ibrutinib</u>, an irreversible <u>Bruton tyrosine kinase</u> (BTK) inhibitor, has shown promise in various B-cell <u>malignancies</u>, including <u>CNSL.</u></p><h3>Objectives</h3><p dir="ltr">This <u>systematic review </u>and meta-analysis aimed to evaluate the safety and efficacy of ibrutinib in the treatment of CNSL, focusing on <u>overall response</u> (OR), complete response (CR), partial response (PR), progression-free survival (PFS), overall survival (OS), and <u>adverse events.</u></p><h3>Methods</h3><p dir="ltr">A comprehensive search of the <u>PubMed</u>, Google Scholar, and <u>Scopus</u> databases was conducted. The included studies were prospective and retrospective studies focusing on ibrutinib as <u>monotherapy</u> or in combination with CNSL. <u>Data extraction</u> and quality assessment were independently performed by two reviewers, and statistical analyses were conducted using R version 4.4.0.</p><h3>Results</h3><p dir="ltr">Fourteen studies (eight <u>cohort studies </u>and six clinical trials) involving 784 patients were included. The median age was 61 years, with nearly equal sex distribution. The meta-analysis for CNSL, the partial response rate was 29.52 %, complete response rate was 49.19 %, and overall response rate was 72.11 %. For PCNSL, the partial response rate was 20.85 %, complete response rate was 48.13 %, and overall response rate was 66.92 %. For SCNSL, the partial response rate was 29.42 %, complete response rate was 44.64 %, and overall response rate was 66.82 %. Significant heterogeneity was observed in some comparisons. There were no significant differences in the efficacy of ibrutinib between CNSL subtypes.</p><h3>Conclusions</h3><p dir="ltr"><u>Ibrutinib</u> shows promising efficacy in improving partial and complete response rates in CNSL. The substantial heterogeneity observed underscores the need for further well-designed studies to confirm these findings and explore the optimal use of ibrutinib in CNSL treatment protocols. Future trials should consider comparing ibrutinib to standard therapies and investigate its long-term efficacy and safety profile.</p><h2>Other Information</h2><p dir="ltr">Published in: Critical Reviews in Oncology/Hematology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.critrevonc.2024.104597" target="_blank">https://dx.doi.org/10.1016/j.critrevonc.2024.104597</a></p> |
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