CASE REPORT article
Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1693481
Orelabrutinib plus Reduced-Dose Whole Brain Radiotherapy in Elderly Primary Central Nervous System Lymphoma: A Case Series
Provisionally accepted
- 1Department of Oncology, Jiangxi Medical College, Nanchang University,, Nanchang University Second Affiliated Hospital, Nanchang, China
- 2Jiangxi Province Key Laboratory of Precision Cell Therapy (2024SSY06241), The Second Affiliated Hospital,, Nanchang University Jiangxi Medical College, Nanchang, China
- 3Jiangxi Provincial Key Laboratory of Hematological Diseases (2024SSY06052), Department of Hematology, TThe Second Affiliated Hospital，, Nanchang University Jiangxi Medical College, Nanchang, China
- 4Department of Hematology, Jiangxi Medical College, Nanchang University,, Nanchang University Second Affiliated Hospital, Nanchang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Primary central nervous system lymphoma (PCNSL) primarily affects elderly individuals, many of whom are unable to tolerate standard high-dose methotrexate (HD-MTX) chemotherapy due to frailty and comorbid conditions. There is a pressing need for alternative treatment strategies that offer reduced toxicity while maintaining therapeutic efficacy. Case presentation: In this case series, we describe three elderly patients (aged 70–78 years) with newly diagnosed, chemotherapy-ineligible PCNSL who were treated with a combination of reduced-dose whole brain radiotherapy (rd-WBRT, <30 Gy) and oral orelabrutinib (150 mg daily).Conclusion: These preliminary findings suggest that the all patients initially achieved either complete remission (CR) or partial remission (PR). Two patients maintained durable remission, whereas one patient experienced disease relapse after discontinuing orelabrutinib and switching to an alternative regimen. No significant neurotoxicity or treatment-related complications were observed. combination of orelabrutinib and rd-WBRT may represent a safe and effective therapeutic approach for elderly patients with PCNSL who are not candidates for standard chemotherapy. Prospective clinical trials are warranted to further evaluate this approach.
Keywords: PCNSL, BTKi, rd-WBRT, elderly patients, Chemotherapy-ineligible, Neurotoxicity
Received: 27 Aug 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Tao, Wang, Wang, Tang, Wu and He. 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: Si Tao, ndefy11188@ncu.edu.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.