Programmed death inhibitors in CNS B-cell lymphoma: A literature review.

Checkpoint inhibitors emerged as a promising therapeutic approach in the management of central nervous system lymphomas, particularly primary and secondary B-cell CNS lymphomas. These are aggressive malignancies and carry a poor prognosis with limited treatment options. Advances in tumor immunology highlighted the role of immune checkpoint pathways, especially PD-1/PD-L1 axis, in facilitating immune evasion in CNS lymphomas. Preclinical studies demonstrated a suppressive tumor microenvironment, often with expression of checkpoint ligands and infiltration by exhausted T cells, suggesting potential sensitivity to immune checkpoint blockade. Clinical experience, including early phase studies, showed encouraging response rates and durable remissions in patients treated with PD-1 inhibitors. Combination strategies incorporating checkpoint inhibitors with targeted therapies are under investigation and may enhance treatment efficacy while maintaining manageable toxicity profiles. As evidence accumulates, checkpoint blockade is increasingly viewed as a potential treatment strategy in CNS lymphomas, warranting further exploration in prospective trials and biomarker-driven studies.