Y. Garcilazo-Reyes, M. Ibañez-Juliá, I. Hernández-Verdin, L. Nguyen-Them, N. Younan, C. Houillier, K. Hoang-Xuan, A. Alentorn
{"title":"精准医学时代治疗中枢神经系统淋巴瘤","authors":"Y. Garcilazo-Reyes, M. Ibañez-Juliá, I. Hernández-Verdin, L. Nguyen-Them, N. Younan, C. Houillier, K. Hoang-Xuan, A. Alentorn","doi":"10.1080/23808993.2020.1777853","DOIUrl":null,"url":null,"abstract":"ABSTRACT Introduction Primary central nervous system lymphoma (PCNSL) is a rare extra-nodal non-Hodgkin lymphoma that in the vast majority of cases belongs to diffuse large B-cell lymphoma (DLBCL) histology. The standard first-line treatment is based on high-dose methotrexate (HD-MTX) regimens. However, the majority of patients will relapse, leading to a poor prognosis of the disease. Areas covered Reviewed are the potential new therapeutic approaches in PCNSL. With the advent of tailored treatment, immunomodulators and immunotherapies are appearing as new promising therapeutic approaches for this orphan disease. This review seeks to summarize the novel approaches currently under evaluation. Expert opinion The therapeutic management of PCNSL is rapidly evolving with the description of PCNSL molecular alterations. However, due to the rarity of this disease, phase III clinical trials using new therapeutic drugs are still lacking. In addition, the vast majority of newly diagnosed PCNSL affect elderly patients, and specific and adapted clinical trials for this fragile population are warranted. Currently, the use of targeted therapies or immune-mediated treatments is only studied in relapsed/refractory (R/R) PCNSL, but the use of these approaches as a first-line treatment (compared with HD-MTX) could also be used as new promising approaches to decrease the toxicity associated with MTX regimens.","PeriodicalId":12124,"journal":{"name":"Expert Review of Precision Medicine and Drug Development","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/23808993.2020.1777853","citationCount":"1","resultStr":"{\"title\":\"Treating central nervous system lymphoma in the era of precision medicine\",\"authors\":\"Y. Garcilazo-Reyes, M. Ibañez-Juliá, I. Hernández-Verdin, L. Nguyen-Them, N. Younan, C. Houillier, K. Hoang-Xuan, A. Alentorn\",\"doi\":\"10.1080/23808993.2020.1777853\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"ABSTRACT Introduction Primary central nervous system lymphoma (PCNSL) is a rare extra-nodal non-Hodgkin lymphoma that in the vast majority of cases belongs to diffuse large B-cell lymphoma (DLBCL) histology. The standard first-line treatment is based on high-dose methotrexate (HD-MTX) regimens. However, the majority of patients will relapse, leading to a poor prognosis of the disease. Areas covered Reviewed are the potential new therapeutic approaches in PCNSL. With the advent of tailored treatment, immunomodulators and immunotherapies are appearing as new promising therapeutic approaches for this orphan disease. This review seeks to summarize the novel approaches currently under evaluation. Expert opinion The therapeutic management of PCNSL is rapidly evolving with the description of PCNSL molecular alterations. However, due to the rarity of this disease, phase III clinical trials using new therapeutic drugs are still lacking. In addition, the vast majority of newly diagnosed PCNSL affect elderly patients, and specific and adapted clinical trials for this fragile population are warranted. Currently, the use of targeted therapies or immune-mediated treatments is only studied in relapsed/refractory (R/R) PCNSL, but the use of these approaches as a first-line treatment (compared with HD-MTX) could also be used as new promising approaches to decrease the toxicity associated with MTX regimens.\",\"PeriodicalId\":12124,\"journal\":{\"name\":\"Expert Review of Precision Medicine and Drug Development\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2020-06-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1080/23808993.2020.1777853\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Precision Medicine and Drug Development\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/23808993.2020.1777853\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Precision Medicine and Drug Development","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/23808993.2020.1777853","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Treating central nervous system lymphoma in the era of precision medicine
ABSTRACT Introduction Primary central nervous system lymphoma (PCNSL) is a rare extra-nodal non-Hodgkin lymphoma that in the vast majority of cases belongs to diffuse large B-cell lymphoma (DLBCL) histology. The standard first-line treatment is based on high-dose methotrexate (HD-MTX) regimens. However, the majority of patients will relapse, leading to a poor prognosis of the disease. Areas covered Reviewed are the potential new therapeutic approaches in PCNSL. With the advent of tailored treatment, immunomodulators and immunotherapies are appearing as new promising therapeutic approaches for this orphan disease. This review seeks to summarize the novel approaches currently under evaluation. Expert opinion The therapeutic management of PCNSL is rapidly evolving with the description of PCNSL molecular alterations. However, due to the rarity of this disease, phase III clinical trials using new therapeutic drugs are still lacking. In addition, the vast majority of newly diagnosed PCNSL affect elderly patients, and specific and adapted clinical trials for this fragile population are warranted. Currently, the use of targeted therapies or immune-mediated treatments is only studied in relapsed/refractory (R/R) PCNSL, but the use of these approaches as a first-line treatment (compared with HD-MTX) could also be used as new promising approaches to decrease the toxicity associated with MTX regimens.
期刊介绍:
Expert Review of Precision Medicine and Drug Development publishes primarily review articles covering the development and clinical application of medicine to be used in a personalized therapy setting; in addition, the journal also publishes original research and commentary-style articles. In an era where medicine is recognizing that a one-size-fits-all approach is not always appropriate, it has become necessary to identify patients responsive to treatments and treat patient populations using a tailored approach. Areas covered include: Development and application of drugs targeted to specific genotypes and populations, as well as advanced diagnostic technologies and significant biomarkers that aid in this. Clinical trials and case studies within personalized therapy and drug development. Screening, prediction and prevention of disease, prediction of adverse events, treatment monitoring, effects of metabolomics and microbiomics on treatment. Secondary population research, genome-wide association studies, disease–gene association studies, personal genome technologies. Ethical and cost–benefit issues, the impact to healthcare and business infrastructure, and regulatory issues.