Wang N, Chen FL, Pan L, Teng Y, Wei XJ, Guo HG, Jiang XM, Huang L, Liu SC, Liang ZL, Li WY. Clinical outcomes of newly diagnosed primary central nervous system lymphoma treated with zanubrutinib-based combination therapy. World J Clin Oncol 2023; 14(12): 606-619 [PMID: 38179402 DOI: 10.5306/wjco.v14.i12.606]
Corresponding Author of This Article
Wen-Yu Li, Doctor, Chief Doctor, School of Medicine, South China University of Technology, No. 123 Huifu West Road, Guangzhou 510006, Guangdong Province, China. lwy80411@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Dec 24, 2023; 14(12): 606-619 Published online Dec 24, 2023. doi: 10.5306/wjco.v14.i12.606
Clinical outcomes of newly diagnosed primary central nervous system lymphoma treated with zanubrutinib-based combination therapy
Ning Wang, Fei-Li Chen, Lu Pan, Yan Teng, Xiao-Juan Wei, Han-Guo Guo, Xin-Miao Jiang, Ling Huang, Si-Chu Liu, Zhan-Li Liang, Wen-Yu Li
Ning Wang, Lu Pan, Yan Teng, Wen-Yu Li, School of Medicine, South China University of Technology, Guangzhou 510006, Guangdong Province, China
Fei-Li Chen, Xiao-Juan Wei, Han-Guo Guo, Xin-Miao Jiang, Ling Huang, Si-Chu Liu, Zhan-Li Liang, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China
Author contributions: The study conception and design were performed by Wang N, Chen FL, and Li WY; Data collection was performed by Wang N; All authors contributed to the data analysis and interpretation; Statistical analysis was performed by Wang N and Chen FL; The first draft of the manuscript was written by Wang N; All authors revised the manuscript.
Institutional review board statement: The study was reviewed and approved by the Guangdong Provincial People’s Hospital Institutional Review Board.
Informed consent statement: All patients provided written informed consent to participate in this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Yu Li, Doctor, Chief Doctor, School of Medicine, South China University of Technology, No. 123 Huifu West Road, Guangzhou 510006, Guangdong Province, China. lwy80411@163.com
Received: June 1, 2023 Peer-review started: June 1, 2023 First decision: August 16, 2023 Revised: September 5, 2023 Accepted: November 17, 2023 Article in press: November 17, 2023 Published online: December 24, 2023 Processing time: 203 Days and 19.4 Hours
ARTICLE HIGHLIGHTS
Research background
Primary central nervous system lymphoma (PCNSL) is an aggressive brain lymphoma with limited treatment options. The current standard treatment involves high-dose methotrexate (HD-MTX), but there is a need for effective combination therapies to address adverse reactions. Zanubrutinib, a Bruton’s tyrosine kinase inhibitor, shows promise owing to its potential to modulate B-cell receptor and Toll-like receptor signaling, which are associated with PCNSL.
Research motivation
This study aimed to evaluate the efficacy and safety of combining zanubrutinib with HD-MTX for newly diagnosed PCNSL patients. Additionally, the study explored the use of circulating tumor DNA (ctDNA) in cerebrospinal fluid (CSF) as a monitoring tool for treatment response.
Research objectives
The main objectives were to assess the treatment outcomes, adverse events, and genomic characteristics of PCNSL patients treated with HD-MTX and zanubrutinib combination therapy, and to investigate the potential of CSF ctDNA in disease surveillance.
Research methods
Nineteen eligible PCNSL patients were included in the study and received HD-MTX and zanubrutinib combination therapy. Clinical responses were evaluated, and ctDNA in CSF was analyzed using next-generation sequencing. Safety, treatment duration, and response were assessed.
Research results
The study demonstrated an overall response rate of 84.2% with the combination therapy, including complete and partial responses. Adverse events were mild and manageable. ctDNA levels in CSF were monitored and correlated with treatment response.
Research conclusions
Zanubrutinib combined with HD-MTX resulted in effective clinical responses in newly diagnosed PCNSL patients. The study highlighted the potential of CSF ctDNA for monitoring treatment response and disease surveillance. This combination therapy demonstrated promising safety and efficacy profiles.
Research perspectives
While the study results are promising, further research with larger patient cohorts and longer follow-up periods is needed to confirm the findings. The potential of zanubrutinib in different molecular subtypes of PCNSL and its long-term effects need to be explored. The clinical use of CSF ctDNA requires further investigation.
