At the 64^th ASH Annual Meeting, Kathryn Tringale, MD, MAS, Memorial Sloan Kettering Cancer Center, New York, NY, discusses outcomes with reduced-dose whole-brain radiation therapy as a consolidation regimen among patients with primary CNS lymphoma, suggesting the prospect of incorporating involved site radiation therapy into this disease paradigm.

Transcript:

I'm Kathryn Tringale. I am a chief resident in radiation oncology at Memorial Sloan Kettering Cancer Center. I've been publishing work on primary CNS lymphoma and investigating our use of consolidation strategies for this disease. As a radiation oncologist, we're very excited to see encouraging outcomes with reduced-dose whole-brain radiation therapy as a consolidation regimen in these patients. Preliminary results of trials, like RTOG-1114, have shown that there's no statistically significant difference in terms of neurotoxicity in these patients, and they actually have very encouraging progression-free survivals. So, incorporating radiation back into the treatment paradigm for this disease is very important because we know that it's an effective tool. So, if we can use it in a way where we're going to actually be able to preserve patients' neurocognition by either reduced doses or reduced volumes, that would be huge.

Our group is very excited about the prospect of incorporating involved site radiation therapy into this disease paradigm. And this is very different because this disease has always been thought to be multifocal in nature, so we've always targeted the whole brain. But our recent findings from our data presented at ASH this year actually show that there is a population of patients who does have local failure, meaning they progress at the original site of disease. And so, these are patients who actually have early failures, so they're either refractory on induction or they fail within 3 months after induction. If they're just having this local side of disease progression, it could be very morbid, and some patients even die from local progression of disease. So, we're very excited to be putting together this prospective clinical trial.

We're going to be incorporating this involved site radiation therapy just to this local site of disease in order to bridge these patients to more definitive therapies. There’re so many advances in the field of primary CNS lymphoma with targeted agents and cellular therapies. And since we know that radiation therapy is a safe and effective treatment approach for this disease, we're excited to be able to incorporate it as a bridging regimen so that more patients are eligible to get some of these newer systemic therapies and ideally achieve cure in a patient population which, otherwise, has really dismal outcomes.