What Is Your Treatment Pathway for CNS Lymphoma?

Grzegorz Nowakowski, MD, of the Mayo Clinic, moderated a discussion on central nervous system (CNS) lymphoma with an expert panel featuring Christian Grommes, MD, of the Memorial Sloan Kettering Cancer Center; Katherine Peters, MD, PhD, of the Preston Robert Tisch Brain Tumor Center; and Avyakta Kallam, MD, of the City of Hope Comprehensive Cancer Center.

In this segment, the experts described how their treatment sequencing for CNS lymphoma begins and how they proceed if patients are responsive to initial therapy. They broached a variety of issues that can be encountered during the initial intervention, such as how patient functional status affects treatment selection, how to assess for secondary CNS lymphoma, and cases where ocular examination is necessary.

The panelists named combination therapy with high-dose methotrexate and chemotherapy as the standard first-line therapy in CNS lymphoma. While treatment requires an aggressive approach, the experts noted patients today have several options that can be explored without having to immediately resort to palliative care.

“Don’t forget that now we’re having more clinical trials that are novel in this space; getting those patients into clinical trials is so critical,” Dr. Peters stressed.