Efficacy and Safety of BTKis in Central Nervous System Lymphoma: A Systematic Review and Meta-Analysis.

Yan Zhang, Jingjing Ye, Hao Chen, Daobin Zhou, Chunyan Ji
Author Information
  1. Yan Zhang: Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China. ORCID
  2. Jingjing Ye: Department of Hematology, Qilu Hospital of Shandong University, Jinan 250012, China.
  3. Hao Chen: College of Acupuncture and Chinese Tuina, Nanjing University of Chinese Medicine, Nanjing 210023, China.
  4. Daobin Zhou: Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China.
  5. Chunyan Ji: Department of Hematology, Qilu Hospital of Shandong University, Jinan 250012, China.

Abstract

BACKGROUND: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Bruton tyrosine kinase inhibitors (BTKis) for central nervous system lymphoma (CNSL).
METHODS: A systematic review was carried out to identify relevant studies from the PubMed, Embase, Cochrane Library, Web of Science, WanFang, CNKI, and CBM databases. The studies included patients with CNSL who received BTKis and reported the overall response (OR), complete remission (CR), and partial response (PR). An overall effect analysis was performed using STATA 15.0. A random-effects model was utilized to calculate the pooled rates, and 95% confidence intervals (CI) were determined for all outcomes.
RESULTS: A total of 21 studies involving 368 patients were included in the meta-analysis. For newly diagnosed CNSL, due to the small simple size, we conducted a quantitative description, and the ORR could reach up to 100%. For relapsed/refractory patients, the pooled ORR was 72% (95% CI: 64-80%, I = 54.89%, = 0.00), with a pooled CR and PR of 43% (95% CI: 33-54%, I = 65.40%, = 0.00) and 23% (95% CI: 13-35%, I = 78.05%, = 0.00), respectively. Most adverse events were hematology-related and generally manageable.
CONCLUSION: BTKis showed acceptable efficacy and safety in treating patients with CNSL. However, large and well-designed trials are still required to confirm BTKis as a treatment for CNSL.

Keywords

References

  1. Exp Hematol Oncol. 2022 Nov 8;11(1):95 [PMID: 36348442]
  2. Transl Cancer Res. 2021 May;10(5):1975-1983 [PMID: 35116520]
  3. Cancer Discov. 2017 Sep;7(9):1018-1029 [PMID: 28619981]
  4. Adv Clin Exp Med. 2023 Aug;32(8):855-863 [PMID: 36881367]
  5. Cancer J. 2019 Nov/Dec;25(6):386-393 [PMID: 31764119]
  6. Neuro Oncol. 2019 Feb 19;21(3):306-313 [PMID: 30423172]
  7. Cancers (Basel). 2022 Feb 02;14(3): [PMID: 35159041]
  8. Arch Public Health. 2014 Nov 10;72(1):39 [PMID: 25810908]
  9. Eur J Cancer. 2019 Aug;117:121-130 [PMID: 31279304]
  10. Blood. 2019 Jan 31;133(5):436-445 [PMID: 30567753]
  11. Br J Haematol. 2021 Mar;192(6):1049-1053 [PMID: 32677095]
  12. Hematol Oncol. 2013 Sep;31(3):143-50 [PMID: 23161567]
  13. Cancer Med. 2020 Nov;9(22):8676-8684 [PMID: 33068336]
  14. Front Oncol. 2022 Jun 16;12:901797 [PMID: 35785180]
  15. Front Oncol. 2022 Nov 17;12:1034668 [PMID: 36465385]
  16. Front Oncol. 2021 Dec 24;11:760405 [PMID: 35004280]
  17. Oncologist. 2020 Sep;25(9):747-e1273 [PMID: 32520407]
  18. Leukemia. 2011 Dec;25(12):1797-807 [PMID: 21818113]
  19. Biomark Res. 2021 May 6;9(1):32 [PMID: 33957995]
  20. J Clin Med. 2021 Sep 29;10(19): [PMID: 34640501]
  21. Br J Haematol. 2023 Jan;200(2):160-169 [PMID: 36408800]
  22. Cancer Cell. 2017 Jun 12;31(6):833-843.e5 [PMID: 28552327]
  23. BMJ. 2021 Mar 29;372:n71 [PMID: 33782057]
  24. Leukemia. 2017 Dec;31(12):2623-2629 [PMID: 28559537]
  25. Blood. 2022 Oct 27;140(17):1907-1916 [PMID: 35789260]
  26. Neurology. 2017 Jan 3;88(1):101-102 [PMID: 27864520]
  27. J Hematol Oncol. 2022 Sep 29;15(1):136 [PMID: 36176002]
  28. Pract Neurol. 2023 Aug;23(4):286-292 [PMID: 36823116]
  29. Eur J Haematol. 2021 Sep;107(3):370-373 [PMID: 34018260]
  30. Front Oncol. 2021 Jul 01;11:707285 [PMID: 34277452]
  31. Br J Haematol. 2020 Jul;190(2):e110-e114 [PMID: 32452526]
  32. Anticancer Res. 2022 Aug;42(8):4173-4178 [PMID: 35896257]
  33. Neurol Int. 2022 Jan 11;14(1):99-108 [PMID: 35076567]
  34. Zhonghua Xue Ye Xue Za Zhi. 2021 Nov 14;42(11):917-922 [PMID: 35045653]
  35. Neuro Oncol. 2021 Jan 30;23(1):122-133 [PMID: 32583848]
  36. Leukemia. 2021 Feb;35(2):312-332 [PMID: 33122850]
  37. Neuro Oncol. 2021 Aug 2;23(8):1231-1251 [PMID: 34185076]
  38. Neuro Oncol. 2023 Jan 5;25(1):37-53 [PMID: 35953526]
  39. Lancet Haematol. 2016 May;3(5):e217-27 [PMID: 27132696]
  40. Invest New Drugs. 2022 Jun;40(3):650-659 [PMID: 35137332]
  41. Ann Lymphoma. 2021 Sep;5:23 [PMID: 35253010]
  42. J Evid Based Med. 2015 Feb;8(1):2-10 [PMID: 25594108]
  43. J Clin Oncol. 2017 Jul 20;35(21):2410-2418 [PMID: 28640701]

Word Cloud

Created with Highcharts 10.0.0=BTKisCNSLpatients095%meta-analysisefficacysafetystudiespooledCI:00systematicreviewBrutontyrosinekinaseinhibitorscentralnervoussystemlymphomaincludedoverallresponseCRPRORRBACKGROUND:aimedevaluateMETHODS:carriedidentifyrelevantPubMedEmbaseCochraneLibraryWebScienceWanFangCNKICBMdatabasesreceivedreportedORcompleteremissionpartialeffectanalysisperformedusingSTATA15random-effectsmodelutilizedcalculateratesconfidenceintervalsCIdeterminedoutcomesRESULTS:total21involving368newlydiagnosedduesmallsimplesizeconductedquantitativedescriptionreach100%relapsed/refractory72%64-80%5489%43%33-54%6540%23%13-35%7805%respectivelyadverseeventshematology-relatedgenerallymanageableCONCLUSION:showedacceptabletreatingHoweverlargewell-designedtrialsstillrequiredconfirmtreatmentEfficacySafetyCentralNervousSystemLymphoma:SystematicReviewMeta-Analysis

Similar Articles

Cited By