Lenalidomide and Rituximab Regimen Combined With Intravitreal Methotrexate Followed by Lenalidomide Maintenance for Primary Vitreoretinal Lymphoma: A Prospective Phase II Study.

Abstract

Primary vitreoretinal lymphoma (PVRL) is a rare variant of primary central nervous system (CNS) lymphoma, for which currently there are no optimal treatment options. This prospective single-center study enrolled immunocompetent patients with newly diagnosed PVRL between August 2018 and January 2020. Patients received local and systemic therapies: intravitreal methotrexate (MTX, 400 μg, 0.1 mL) injections for 1 year (total 16 injections) and six cycles of the rituximab (375 mg/m2 on day 1) and lenalidomide (25 mg on day 1-21; R2) regimen. Lenalidomide was maintained for 2 years in patients who had achieved a response. We enrolled 11 patients with a mean age of 58 (range, 48-70) years, of which 10 achieved complete remission at the first evaluation. The median follow-up period was 18.3 (range, 10.6-27.8) months, and the median progression-free survival was 12.7 months. Moreover, a total of eight patients relapsed. The most common adverse event (AE) was neutropenia, which occurred in seven patients (63.6%), followed by grade 3 ocular toxicities, including cataract formation, in six patients (54%). These findings suggest that the R2 regimen combined with intravitreal MTX, followed by lenalidomide maintenance, is a safe option for PVRL with moderate efficacy. This trial is registered with ClinicalTrials.gov (number NCT03746223).

• Authors: Yan Zhang, Xiao Zhang, Dongmei Zou, Jingjing Yin, Li Zhang, Xuan Wang, Congwei Jia, Wei Wang, Danqing Zhao, Daobin Zhou, Wei Zhang, Meifen Zhang
• Journal: Frontiers in oncology (Front Oncol) Vol. 11 Pg. 701507 ( 2021) ISSN: 2234-943X [Print] Switzerland
• PMID: 34249763 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Zhang, Zhang, Zou, Yin, Zhang, Wang, Jia, Wang, Zhao, Zhou, Zhang and Zhang.