Evidence map›Paper›PMID 35441948›Full record

ArticleJournal of neuro-oncology2022

High-dose methotrexate and rituximab induction regimen in immunocompetent patients with primary CNS lymphoma: a retrospective single-center study of survival predictors.

Andrew B DeAtkine, Moaaz Abdelrashid, Zach Tucker, Amitkumar Mehta, James M Markert, Jinsuh Kim, John B Fiveash, Robert A Oster, Mina Lobbous, L Burt Nabors

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In one paragraph

Article in Journal of neuro-oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Andrew B DeAtkineHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Moaaz AbdelrashidDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Zach TuckerDivision of Neuro-Oncology, Department of Neurology, University of Alabama at Birmingham, FOT 1020 | 510 20th Street South, Birmingham, AL, 35233, USA.
Amitkumar MehtaDivision of Hematology and Oncology, Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
James M MarkertDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Jinsuh KimDepartment of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
John B FiveashDepartment of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL, USA.
Robert A OsterO'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
Mina Lobbous *Division of Neuro-Oncology, Department of Neurology, University of Alabama at Birmingham, FOT 1020 | 510 20th Street South, Birmingham, AL, 35233, USA.
L Burt Nabors *Division of Neuro-Oncology, Department of Neurology, University of Alabama at Birmingham, FOT 1020 | 510 20th Street South, Birmingham, AL, 35233, USA. bnabors@uabmc.edu.
University of Alabama at Birmingham · US

Funding

XRAY CRYSTALLOGRAPHYP30CA013148 · NCI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Robert S Welner · 1985 to 2026
$165.9M
NCI NIH HHS P30 CA013148
6 · The paper itself

Abstract

purposePrimary Central Nervous System Lymphoma (PCNSL) is an aggressive tumor that is confined to the CNS. Although the provision of high-dose methotrexate (HD-MTX) has remarkably improved outcomes in PCNSL patients, the optimal treatment regimens and standard MTX dose for induction therapy have been largely controversial. Herein, we sought to explore the impact of adjuvant rituximab and different dosages of induction HD-MTX on survival outcomes of immunocompetent patients with PCNSL.

methodsIn this study, we examined patients with PCNSL treated at a single NCI-designated comprehensive cancer center to evaluate their survival outcomes. We conducted a retrospective analysis of 51 immunocompetent patients with PCNSL who received their induction chemotherapy at the University of Alabama at Birmingham (UAB) between 2001 and 2019. Only adult patients with a confirmed diagnosis of PCNSL who had either HD-MTX alone or in combination with rituximab were included. Patients' demographics, clinical characteristics, and survival data were collected and analyzed.

resultsThere is no significant difference in survival among patients who received MTX alone versus MTX plus rituximab (HR = 0.996 (95% CI: 0.398-2.493), p = 0.994). Lower doses of MTX were associated with worse survival outcomes (HR = 0.680 (95% CI: 0.530-0.872), p = 0.002); however, this difference in survival was not significant when adjusted to age (HR = 0.797 (95% CI: 0.584-1.088), p = 0.153).

conclusionOur experience challenges the role of rituximab in PCNSL during induction therapy. Our study also highlights the shorter survival in elderly patients with PCNSL which can be related, to some extent, to the relatively lower doses of HD-MTX. There is an unmet need to establish a consensus on the most effective upfront regimen in PCNSL through prospective studies.

Indexed as

Central Nervous System NeoplasmsLymphomaAdultAgedAntineoplastic Combined Chemotherapy ProtocolsHumansMethotrexateProspective StudiesRetrospective StudiesRituximabMethotrexateRituximabHD-MTXMethotrexateOutcomesPCNSLPrimary CNS LymphomaRituximab

Identifiers

PMID35441948
OpenAlexW4225853628

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.