TY - JOUR
T1 - Increasing use of immunotherapy and prolonged survival among younger patients with primary CNS lymphoma
T2 - a population-based study
AU - Neuhauser, Magdalena
AU - Roetzer, Thomas
AU - Oberndorfer, Stefan
AU - Kitzwoegerer, Melitta
AU - Payer, Franz
AU - Unterluggauer, Julia J
AU - Haybaeck, Johannes
AU - Stockhammer, Günther
AU - Iglseder, Sarah
AU - Moser, Patrizia
AU - Thomé, Claudius
AU - Stultschnig, Martin
AU - Wuertz, Franz
AU - Brandner-Kokalj, Tanisa
AU - Weis, Serge
AU - Bandke, Dave
AU - Pichler, Josef
AU - Hutterer, Markus
AU - Krenosz, Karl J
AU - Boehm, Alexandra
AU - Mayrbaeurl, Beate
AU - Hager-Seifert, Andrea
AU - Kaufmann, Hannes
AU - Dumser, Martina
AU - Reiner-Concin, Angelika
AU - Hoenigschnabl, Selma
AU - Kleindienst, Waltraud
AU - Hoffermann, Markus
AU - Dieckmann, Karin
AU - Kiesel, Barbara
AU - Widhalm, Georg
AU - Marosi, Christine
AU - Jaeger, Ulrich
AU - Hainfellner, Andreas
AU - Hackl, Monika
AU - Hainfellner, Johannes A
AU - Preusser, Matthias
AU - Woehrer, Adelheid
N1 - Funding Information:
This study was supported by the Anniversary Fund of the Oesterreichische Nationalbank under grant agreement 16725 to AW. Additional funding for ABTR was provided by unrestricted research grants of Roche, the Austrian Society of Neurology, and AbbVie.
Funding Information:
This study was supported by the Anniversary Fund of the Oesterreichische Nationalbank under grant agreement 16725 to AW. Additional funding for ABTR was provided by unrestricted research grants of Roche, the Austrian Society of Neurology, and AbbVie. We thank Dr. Johanna Klughammer, Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna for help with graphical representations using R© software and Dr. Harald Heinzl, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna for statistical advice. Part of the samples and/or data used for this research project were kindly provided by Biobank Graz.
Publisher Copyright:
© 2019, © 2019 Acta Oncologica Foundation.
PY - 2019/7/3
Y1 - 2019/7/3
N2 - Background: Primary CNS lymphoma is a highly aggressive and rare type of extranodal non-Hodgkin lymphoma. Although, new therapeutic approaches have led to improved survival, the management of the disease poses a challenge, practice patterns vary across institutions and countries, and remain ill-defined for vulnerable patient subgroups. Material and Methods: Using information from the Austrian Brain Tumor Registry we followed a population-based cohort of 189 patients newly diagnosed from 2005 to 2010 through various lines of treatment until death or last follow-up (12-31-2016). Prognostic factors and treatment-related data were integrated in a comprehensive survival analysis including conditional survival estimates. Results: We find variable patterns of first-line treatment with increasing use of rituximab and high-dose methotrexate (HDMTX)-based poly-chemotherapy after 2007, paralleled by an increase in median overall survival restricted to patients aged below 70 years. In the entire cohort, 5-year overall survival was 24.4% while 5-year conditional survival increased with every year postdiagnosis. Conclusion: In conclusion, we show that the use of poly-chemotherapy and immunotherapy has disseminated to community practice to a fair extent and survival has increased over time at least in younger patients. Annually increasing conditional survival rates provide clinicians with an adequate and encouraging prognostic measure.
AB - Background: Primary CNS lymphoma is a highly aggressive and rare type of extranodal non-Hodgkin lymphoma. Although, new therapeutic approaches have led to improved survival, the management of the disease poses a challenge, practice patterns vary across institutions and countries, and remain ill-defined for vulnerable patient subgroups. Material and Methods: Using information from the Austrian Brain Tumor Registry we followed a population-based cohort of 189 patients newly diagnosed from 2005 to 2010 through various lines of treatment until death or last follow-up (12-31-2016). Prognostic factors and treatment-related data were integrated in a comprehensive survival analysis including conditional survival estimates. Results: We find variable patterns of first-line treatment with increasing use of rituximab and high-dose methotrexate (HDMTX)-based poly-chemotherapy after 2007, paralleled by an increase in median overall survival restricted to patients aged below 70 years. In the entire cohort, 5-year overall survival was 24.4% while 5-year conditional survival increased with every year postdiagnosis. Conclusion: In conclusion, we show that the use of poly-chemotherapy and immunotherapy has disseminated to community practice to a fair extent and survival has increased over time at least in younger patients. Annually increasing conditional survival rates provide clinicians with an adequate and encouraging prognostic measure.
KW - Adolescent
KW - Adult
KW - Aged
KW - Antineoplastic Agents, Immunological/therapeutic use
KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
KW - Austria/epidemiology
KW - Brain Neoplasms/drug therapy
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Lymphoma, Non-Hodgkin/drug therapy
KW - Male
KW - Methotrexate/therapeutic use
KW - Middle Aged
KW - Prognosis
KW - Progression-Free Survival
KW - Registries/statistics & numerical data
KW - Rituximab/therapeutic use
KW - Survival Analysis
KW - Young Adult
UR - http://www.scopus.com/inward/record.url?scp=85064592876&partnerID=8YFLogxK
U2 - 10.1080/0284186X.2019.1599137
DO - 10.1080/0284186X.2019.1599137
M3 - Journal article
C2 - 30994047
SN - 0284-186X
VL - 58
SP - 967
EP - 976
JO - Acta Oncologica
JF - Acta Oncologica
IS - 7
ER -