Pharmacotherapy for primary CNS lymphoma: Progress beyond methotrexate?

Jerome J. Graber, Antonio Omuro

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations


Studies conducted in the 1990s have established that high-dose methotrexate-based chemotherapy added to whole-brain radiotherapy improves survival in primary CNS lymphoma (PCNSL). However, radiotherapy-related delayed neurotoxicity has emerged as a serious complication of chemo-radiotherapy, particularly in the elderly. Unfortunately, omitting radiotherapy results in decreased progression-free survival, and therefore establishing more effective chemotherapy regimens is necessary in order to improve the number of long-term remissions. Recent studies have suggested that a combination of drugs is superior to single-agent methotrexate, but the optimal chemotherapy combination and the role of alternative consolidation treatments such as reduced-dose radiotherapy and high-dose chemotherapy with stem cell rescue remain to be defined. In this article, we review the multiple chemotherapy options reported in newly diagnosed and in progressiverefractory PCNSL, including recently reported and ongoing clinical trials, as well as future perspectives.

Original languageEnglish (US)
Pages (from-to)447-457
Number of pages11
JournalCNS Drugs
Issue number6
StatePublished - Jun 13 2011


  • Antineoplastics
  • CNS-cancer
  • Lymphoma
  • Methotrexate
  • Radiotherapy
  • Stem-cell-transplant

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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