Advances in Primary Central Nervous System Lymphoma

Area of Science:

• Neuro-oncology
• Hematology
• Genomics

Background:

• Primary CNS lymphoma (PCNSL) management significantly impacts long-term patient outcomes.
• Advances in diagnosis and treatment are rapidly evolving the field.

Purpose of the Study:

• To review recent advancements in the diagnosis and treatment of PCNSL.
• To discuss the current state of the field, focusing on outcomes in different age groups.

Main Methods:

• Review of recent literature on PCNSL diagnosis and treatment.
• Analysis of genomic data from cerebrospinal fluid (CSF) cell-free DNA.
• Evaluation of prospective clinical trial data for first-line and salvage therapies.

Main Results:

• Genomic analysis of CSF cell-free DNA is a novel diagnostic tool for PCNSL.
• Chemotherapy-based first-line treatments yield high cure rates in younger patients (<60-65 years).
• Older patients exhibit poor outcomes, with investigational therapies like BTK inhibitors and CAR-T cells showing promise.

Conclusions:

• Curative treatment is achievable for younger PCNSL patients, with future focus on reducing toxicity and neurocognitive deficits.
• Effective treatment strategies for older PCNSL patients remain a critical unmet need.
• Ongoing clinical trials are exploring new therapeutic avenues for PCNSL.