{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:18:45Z","timestamp":1790788725107,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Primary central nervous system (CNS) lymphoma (PCNSL) is a rare and aggressive lymphoma that affects the CNS without other systemic involvement. High\u2010dose methotrexate (HDMTX)\u2010based regimens are recommended frontline treatment, followed by consolidation with either high\u2010dose chemotherapy, whole brain radiation (WBRT) +\/\u2212 sequential temozolomide (TMZ), or autologous stem cell transplant (autoSCT). Despite advancements with HDMTX and rituximab, up to half of patients will relapse. Treatment for relapsed or refractory (R\/R) disease varies widely as preferred regimens are not well\u2010established. Our study aimed to provide real\u2010world characterization of R\/R PCNSL therapies. The secondary objective was characterization of consolidation methods after frontline treatment. This retrospective, descriptive analysis included 54 adult PCNSL patients that received a HDMTX\u2010based frontline regimen between 4\/1\/2016 and 7\/1\/2022. Patients receiving HDMTX for the purpose of secondary CNS lymphoma, non\u2010B cell origin PCNSL, and intraocular lymphoma were excluded. Thirty\u2010one patients (57%) received consolidation therapy with rituximab and high\u2010dose cytarabine (R\u2010HDAC), WBRT, or both. Thirteen patients (24%) proceeded with autoSCT. Twenty\u2010five patients had disease progression, with 17 patients receiving second line treatment. The second line treatments were WBRT (24%), clinical trial (18%), rituximab with lenalidomide (R\n                    <jats:sup>2<\/jats:sup>\n                    ; 18%), re\u2010induction with HDMTX\u2010based regimens (18%), ibrutinib with rituximab (12%) and R\u2010HDAC (12%). Seven patients progressed, and all received third line treatment. Treatments varied, including R\n                    <jats:sup>2<\/jats:sup>\n                    ; ibrutinib +\/\u2212 HDMTX; rituximab, methotrexate, and cytarabine; R\u2010HDAC; R\u2010nivolumab; and WBRT. Five patients received a fourth line regimen of R +\/\u2212 lenalidomide, R\u2010HDMTX, or nivolumab monotherapy. Regimens used for the three patients who received fifth line treatment and beyond included R\u2010TMZ and pembrolizumab monotherapy in addition to previously described regimens. Regimen selection is varied and highly dependent on physician preference and patient factors, including\u00a0clinical trial eligibility, prior therapies, performance status, organ function, and treatment intent. Prospective clinical trials are needed to guide optimal management.\n                  <\/jats:p>","DOI":"10.1002\/hon.3313","type":"journal-article","created":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T00:53:59Z","timestamp":1727484839000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characterizing second line and beyond therapies for primary central nervous system lymphomas"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9907-8363","authenticated-orcid":false,"given":"Brian","family":"Primeaux","sequence":"first","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9380-6502","authenticated-orcid":false,"given":"Chelsea","family":"Luo","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6055-3008","authenticated-orcid":false,"given":"Erin K.","family":"Yeung","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2150-9722","authenticated-orcid":false,"given":"Caitlin","family":"Linger","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9757-2325","authenticated-orcid":false,"given":"Sheree","family":"Chen","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2094-3191","authenticated-orcid":false,"given":"Bryan","family":"Do","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010023\u201000439\u20100"},{"key":"e_1_2_9_3_1","unstructured":"NCCN.Central nervous system cancers version 1.2023. 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