Table 1 Pharmacokinetics of Agents Recommended by NCCN Guideline for PCNSL
From: Current and emerging therapies for primary central nervous system lymphoma
| Â | Preferred regimens | Agent a | MW (Da) | Route | Protein binding (%) | CSF (brain)/blood (%) | Reference |
|---|---|---|---|---|---|---|---|
Induction | R+MTX(8) R+MTX(8)+ TMZ R+M(3.5)VP(+WBRT in con.) R+MTX(3.5)+TMZ(+WBRT in con.) | MTX(M) | 454 | iv | 46.5-54 | 2-20 | |
rituximab(R) | 143857 | iv | NA | 0.1 | |||
temozolomide (TMZ) | 194 | oral | 15 | 20-30 | |||
procarbazine(P) | 221 | oral | NA | NA | [32] | ||
vincristine(V) | 824 | iv | 75 | undetected | [33] | ||
Consolidation | ASCT with condition regimen BCNU+T TBC HD-AraC(±VP16) | thiotepa(T) | 189 | iv | NA | 95-100 | [34] |
carmustine (BCNU) | 214 | iv | 80 | 20-30 | [35] | ||
Busulfan(B) | 246 | iv | 32 | 95 | [36] | ||
cyclophosphamide(C) | 261 | iv | 20 | 50 | [37] | ||
etoposide (VP16) | 589 | iv | 97 | 0.5-5 | [38] | ||
cytarabine (AraC) | 243 | iv | 13 | 6-22 | |||
Refractory/Relapse | Retreat with HD-MTX ±R +R+ibrutinib Ibrutinib TMZ Lenalidomide or others | ibrutinib | 440 | oral | irreversible | 1-20(28.7c) | |
lenalidomide | 259 | oral | 30 | 11p-20 | |||
topotecan | 421 | iv/oral | 35 | 13-68 | [44] | ||
cisplatin | 300 | iv | 90 | 50 | [45] | ||
pemetrexed | 427 | iv | 81 | <5 | [46] | ||
pomalidomide | 273 | oral | 12-44 | 17-19 | [15] |