Major studies investigating the role of CNS prophylaxis in DLBCL
| Study . | Centers . | Patients . | First-line treatment and CNS prophylaxis . | CNS relapse . |
|---|---|---|---|---|
| Orellana-Noia et al, Blood 09/2021 | 21 US centers | n = 1130 Median age, 62 y 30% high CNS-IPI | R-CHOP/R-CHOP-like with IT MTX: n = 894 with HD MTX: n = 236 | 5.4% (IT MTX) vs 6.8% (HD MTX) (P = .4) |
| Ong et al, Blood Cancer Journal 08/2021 | Oligocentric Singapore | n = 226 Median age, 65 y 85% high CNS-IPI | R-CHOP with HD MTX: n = 66 w/o: n = 160 | 3-y risk (isolated CNS relapse): 3.1% (HD MTX) vs 14.6% (w/o) (P = .032) |
| Bobillo et al, Blood Cancer Journal 06/2021 | Monocentric New York | n = 585 Median age, 68 y 68% high CNS-IPI | R-CHOP/R-CHOP-like with IT MTX: n = 253 with HD MTX: n = 42 w/o: n = 290 | 5-y risk: 5.5% (IT MTX), 5% (HD MTX), and 7.5% (w/o) (P = .34) |
| Jeong et al, Blood Advances 04/2021 | Monocentric Seoul | n = 258 Median age, 62 y 49% high CNS-IPI | R-CHOP with HD MTX: n = 128 w/o: n = 130 | 2-y cumulative incidence: 12.4% (HD MTX) vs 13.9 (w/o) (P = .96) |
| Puckrin et al, American Journal of Hematology 04/2021 | Alberta Cancer Registry Canada | n = 326 Median age, 63 y 88% high CNS-IPI | R-CHOP-like or more intense with HD MTX: n = 115 w/o: n = 211 | 11.2% (HD MTX) vs 12.2% (w/o) (P = .82) |
| Eyre et al, British Journal of Hematology 10/2019 | 8 UK centers | n = 690 Median age, 77 y 40% high CNS-IPI | R-CHOP with IT MTX: n = 97 with HD MTX: n = 14 both: n = 17 w/o: n = 552 | Adjusted for CNS IPI: HR 1.34 (95% CI, 0.46-3.86) (P = .59) (IT MTX/HD MTX/both vs w/o) |
| Klanova et al, Blood 02/2019 | Multicentric GOYA (phase 3 trial) | n = 1418 Median age, 62 y 17% high CNS-IPI | R/G-CHOP with IT MTX and/or AraC: n = 140 w/o: n = 1278 | 2-y risk: 2.8% (IT MTX) vs 2.6% (w/o) |
| Boehme et al, Blood 04/2009 | Multicentric RICOVER-60 (phase 3 trial) | n = 1222 Median age, 68 y | (R)-CHOP with IT MTX: n = 273 w/o: n = 949 | CNS events: 2.5% (IT MTX) vs 4.4% (w/o) |
| Study . | Centers . | Patients . | First-line treatment and CNS prophylaxis . | CNS relapse . |
|---|---|---|---|---|
| Orellana-Noia et al, Blood 09/2021 | 21 US centers | n = 1130 Median age, 62 y 30% high CNS-IPI | R-CHOP/R-CHOP-like with IT MTX: n = 894 with HD MTX: n = 236 | 5.4% (IT MTX) vs 6.8% (HD MTX) (P = .4) |
| Ong et al, Blood Cancer Journal 08/2021 | Oligocentric Singapore | n = 226 Median age, 65 y 85% high CNS-IPI | R-CHOP with HD MTX: n = 66 w/o: n = 160 | 3-y risk (isolated CNS relapse): 3.1% (HD MTX) vs 14.6% (w/o) (P = .032) |
| Bobillo et al, Blood Cancer Journal 06/2021 | Monocentric New York | n = 585 Median age, 68 y 68% high CNS-IPI | R-CHOP/R-CHOP-like with IT MTX: n = 253 with HD MTX: n = 42 w/o: n = 290 | 5-y risk: 5.5% (IT MTX), 5% (HD MTX), and 7.5% (w/o) (P = .34) |
| Jeong et al, Blood Advances 04/2021 | Monocentric Seoul | n = 258 Median age, 62 y 49% high CNS-IPI | R-CHOP with HD MTX: n = 128 w/o: n = 130 | 2-y cumulative incidence: 12.4% (HD MTX) vs 13.9 (w/o) (P = .96) |
| Puckrin et al, American Journal of Hematology 04/2021 | Alberta Cancer Registry Canada | n = 326 Median age, 63 y 88% high CNS-IPI | R-CHOP-like or more intense with HD MTX: n = 115 w/o: n = 211 | 11.2% (HD MTX) vs 12.2% (w/o) (P = .82) |
| Eyre et al, British Journal of Hematology 10/2019 | 8 UK centers | n = 690 Median age, 77 y 40% high CNS-IPI | R-CHOP with IT MTX: n = 97 with HD MTX: n = 14 both: n = 17 w/o: n = 552 | Adjusted for CNS IPI: HR 1.34 (95% CI, 0.46-3.86) (P = .59) (IT MTX/HD MTX/both vs w/o) |
| Klanova et al, Blood 02/2019 | Multicentric GOYA (phase 3 trial) | n = 1418 Median age, 62 y 17% high CNS-IPI | R/G-CHOP with IT MTX and/or AraC: n = 140 w/o: n = 1278 | 2-y risk: 2.8% (IT MTX) vs 2.6% (w/o) |
| Boehme et al, Blood 04/2009 | Multicentric RICOVER-60 (phase 3 trial) | n = 1222 Median age, 68 y | (R)-CHOP with IT MTX: n = 273 w/o: n = 949 | CNS events: 2.5% (IT MTX) vs 4.4% (w/o) |
AraC, cytosine arabinoside; CI, confidence interval; G, obinutuzumab, HD, high dose; HR, hazard ratio; R-CHOP, rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone; w/o, without prophylaxis.