Methotrexate area under the curve as a prognostic factor in primary central nervous system lymphoma treated with immunochemoradiotherapy Journal Article


Authors: Morris, P. G.; Abrey, L. E.; Reiner, A. S.; Wu, N.; Panageas, K. S.; Seko, B. S.; Deangelis, L. M.; Omuro, A.
Article Title: Methotrexate area under the curve as a prognostic factor in primary central nervous system lymphoma treated with immunochemoradiotherapy
Abstract: A higher methotrexate area under the curve (MTX AUC) observed during the first chemotherapy cycle has been associated with improved tumor control in patients with primary central nervous system lymphoma. To confirm these findings, we conducted a post hoc analysis of data from a prospective phase II trial of rituximab, methotrexate, procarbazine, vincristine, cytarabine, and low-dose radiotherapy. Thirty-nine patients were included (24 men; 15 women). The median age was 60 years (range 3076) and median Karnofsky performance status (KPS) score was 70 (range 50100). There was substantial inter-individual variability in MTX AUC (median: 795.5 μM*h/L, range 44.88326.44). However, there were no differences in progression-free survival (PFS) in patients below and above the median MTX AUC (2-year PFS 78% vs. 85% respectively; p=0.51). Similarly, there were no differences in response rates or overall survival according to MTX AUC, suggesting that intra-patient dose escalation to increase MTX exposure is unnecessary when our regimen is utilized. © 2011 Informa UK, Ltd.
Keywords: adult; cancer chemotherapy; cancer survival; clinical article; aged; middle aged; survival analysis; overall survival; area under the curve; cancer radiotherapy; combined modality therapy; primary central nervous system lymphoma; cytarabine; methotrexate; rituximab; cancer immunotherapy; progression free survival; multiple cycle treatment; antineoplastic combined chemotherapy protocols; vincristine; procarbazine; central nervous system neoplasms; whole body radiation; karnofsky performance status; folinic acid; area under curve; maximum plasma concentration; drug blood level; primary cns lymphoma; recombinant granulocyte colony stimulating factor; post hoc analysis; immunochemoradiotherapy; antibodies, monoclonal, murine-derived
Journal Title: Leukemia and Lymphoma
Volume: 52
Issue: 10
ISSN: 1042-8194
Publisher: Taylor & Francis Group  
Date Published: 2011-10-01
Start Page: 1891
End Page: 1897
Language: English
DOI: 10.3109/10428194.2011.585527
PROVIDER: scopus
PUBMED: 21699456
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 2 November 2011" - "CODEN: LELYE" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Anne S Reiner
    120 Reiner
  2. Patrick Glyn Morris
    107 Morris
  3. Antonio Marcilio Padula Omuro
    176 Omuro
  4. Lauren E Abrey
    272 Abrey
  5. Katherine S Panageas
    327 Panageas
  6. Nian Wu
    30 Wu
  7. Brian Stephen Seko
    3 Seko