Yadav BS. High-dose methotrexate and zanubrutinib combination therapy for primary central nervous system lymphoma. World J Clin Oncol 2024; 15(3): 371-374 [PMID: 38576595 DOI: 10.5306/wjco.v15.i3.371]
Corresponding Author of This Article
Budhi Singh Yadav, MD, Professor, Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education & Research, Regional Cancer Centre, Sector 12, Chandigarh 160012, India. drbudhi@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Editorial
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. Mar 24, 2024; 15(3): 371-374 Published online Mar 24, 2024. doi: 10.5306/wjco.v15.i3.371
High-dose methotrexate and zanubrutinib combination therapy for primary central nervous system lymphoma
Budhi Singh Yadav
Budhi Singh Yadav, Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, India
Author contributions: Yadav BS contributed to concept design, literature review, manuscript writing, revision, final approval.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Budhi Singh Yadav, MD, Professor, Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education & Research, Regional Cancer Centre, Sector 12, Chandigarh 160012, India. drbudhi@gmail.com
Received: November 23, 2023 Peer-review started: November 23, 2023 First decision: January 12, 2024 Revised: January 13, 2024 Accepted: February 20, 2024 Article in press: February 20, 2024 Published online: March 24, 2024
Abstract
In this editorial I comment on the article, published in the current issue of the World Journal of Clinical Oncology. Primary central nervous system lymphoma (PCNSL) is a disease of elderly and immunocompromised patients. The authors reported clinical results of 19 patients with PCNSL treated with zanubrutinib/high dose methotrexate (HD-MTX) until disease progression. They demonstrated that the combination of zanubrutinib with HD-MTX led to a marked clinical response and tolerability among these patients. They also observed that cerebrospinal fluid liquid biopsy to detect circulating tumor DNA may be a good option for evaluating treatment response and tumor burden in patients with PCNSL. PCNSL is a challenging disease for treatment as these patients present with different neurological states and comorbidities. Treatment has evolved over the years from whole brain radiotherapy to HD-MTX followed by autologous stem cell transplant. Gradually, treatment of patients with PCNSL is going to become individualized.
Core Tip: Primary central nervous system lymphoma is treated with high dose methotrexate induction followed by consolidation with whole-brain radiotherapy or autologous stem cell transplant. Depending on the general condition and disease status of these patients they can be offered maintenance therapy. Zanbrutinib may be offered to these patients for maintaining the response to primary treatment.
