ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuro-Oncology and Neurosurgical Oncology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1570224
Efficacy of Individualized Orelabrutinib-Based Regimens in Relapsed or Refractory Central Nervous System Lymphoma
Provisionally accepted
Yuchen Wu1Xuefei Sun1
Liwei Lv2
Qu Cui1Jun Qian1Ruixian Xing1Xueyan Bai1
Yuedan Chen1Qing Liu1Wenyuan Lai1Chunji Gao3
Shengjun Sun1Nan Ji1
Yuanbo Liu1*- 1Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- 2Beijing Tongren Hospital, Capital Medical University, Beijing, Beijing Municipality, China
- 3Department of Hematology, Chinese PLA General Hospital, Beijing, China
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Background: Relapsed or refractory central nervous system lymphoma (rrCNSL) lacks established preferred treatment and carries an inferior prognosis. Bruton’s tyrosine kinase inhibitor (BTKi) showed promising effectiveness. Orelabrutinib is a second-generation BTKi with a high concentration in cerebrospinal fluid.Methods: In this retrospective analysis, the outcomes of 37 relapsed or refractory central nervous system diffuse large B-cell lymphoma patients who received orelabrutinib, high-dose methotrexate, ifosfamide, etoposide, and dexamethasone (Ore-MIED) or orelabrutinib, high-dose methotrexate, temozolomide and dexamethasone (Ore-MTD) were evaluated. Results: Of the 37 patients included, 11 received Ore-MTD, and 26 received the Ore-MIED regimen. The overall response rate in our cohort was 89.2%, with complete remission achieved in 51.4% of patients and partial remission in 37.8% of patients. The median progression-free survival was observed to be 7.0 months. No statistically significant difference was found in the median progression-free survival between patients receiving different treatment regimens (5.0 months for Ore-MTD versus 13.0 months for Ore-MIED; p=0.29). Moreover, the median overall survival has not been reached in this cohort, indicating a promising outcome despite the aggressive nature of the disease. Conclusions: Our study confirms the effectiveness and safety of Ore-MIED/Ore-MTD in rrCNSL patients, even in those with previous exposure to multiple lines of treatment.
Keywords: central nervous system lymphoma, Relapsed or refractory, Bruton's tyrosine kinase, Orelabrutinib, Methotrexate
Received: 03 Feb 2025; Accepted: 13 May 2025.
Copyright: © 2025 Wu, Sun, Lv, Cui, Qian, Xing, Bai, Chen, Liu, Lai, Gao, Sun, Ji and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yuanbo Liu, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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