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2024-02-12T14:33:58.000Z

HOVON NHL 24 trial: Rituximab plus MBVP in PCNSL

Feb 12, 2024
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Learning objective: After reading this article, learners will be able to cite a new clinical development in primary central nervous system lymphoma.

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Studies have reported conflicting results on the benefit of rituximab in combination with chemotherapy in patients with newly diagnosed primary central nervous system lymphoma (PCNSL). Here, we summarize the long-term results after a median follow-up of 82.3 months of phase III HOVON NHL 24 trial published by Bromberg et al.1 in Neuro-oncology investigating patients treated with methotrexate, BCNU (bis-chloroethylnitrosourea, carmustine), teniposide, and prednisolone (MBVP) with and without rituximab.

Study design1

  • In total, 199 patients with newly diagnosed PCNSL were enrolled and randomized to MBVP with and without rituximab
  • The primary endpoint was event-free survival

Results1

  • Patients were aged 18–70 years
  • Event-free survival hazard ratio was not statistically different between treatment groups (0.85, p = 0.33)
  • Overall survival rate at 5 years was higher in patients treated with rituximab than without (53% vs 49%, respectively)
  • Mortality and disease progression were higher in patients treated with MBVP alone compared with in combination with rituximab (64% vs 55.5% and 63% vs 48%, respectively)

Safety1

  • PCNSL was the most common cause of death in patients treated with and without rituximab (69% and 70%, respectively), complication of treatment was the second most common cause of death (6% and 5%, respectively)

Key learnings

  • Rituximab did not improve survival outcomes and therefore, may not be beneficial to patients with newly diagnosed PCNSL
  • A significant proportion of patients have persistent clinically relevant fatigue after MBVP treatment confirming further treatment options are required to target this

  1. Bromberg JEC, Issa S, van der Holt B, et al. Survival, neurocognitive function, and health-related quality of life outcomes after rituximab—methotrexate, BCNU, teniposide, and prednisolone for primary CNS lymphoma: Final results of the HOVON 105/ALLG NHL 24 study. Neuro-Oncol. Published online ahead of print. DOI: 10.1093/neuonc/noad224

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