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Real-world comparison of BTK inhibitors and lenalidomide as first-line maintenance in primary CNS lymphoma: a multi-center retrospective study 期刊论文

编号：

8B1AC9894304E4CFEC7FB78CCDA37F41
作者：

Chang, Xiaoli#^[1,4]He, Zhangyuting#^[2]Wang, Huanyuan^[1];Zhu, Huiying^[2];Guo, Yixian^[1,4];Zou, Dongmei^[1,4];Zhao, Zhilian^[1,5];Song, Tianbin^[1,5];Hu, Ronghua^[1,4];Ni, Jing^[1,4];Zhao, Hong^[1,4];Hui, Wuhan^[1,4];Liu, Zixian(刘子闲)^[3]Li, Zhenling(李振玲)^[3]Zhang, Wei^[2];Zhou, Daobin^[2];Zhang, Yan*^[2]Sun, Wanling*^[1,4]
语种：

英文
期刊：

JOURNAL OF NEURO-ONCOLOGY ISSN：0167-594X 2026 年 177 卷 1 期 ; MAR
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关键词：

Maintenance therapy BTK inhibitors Lenalidomide Efficacy Primary central nervous system lymphoma
摘要：

Background Primary central nervous system lymphoma (PCNSL) is a rare, aggressive malignancy presenting significant therapeutic challenges. Optimal maintenance therapy following initial remission remained debated. Methods We conducted a multicentre, real-world study comparing BTK inhibitors (BTKi, n = 23) versus lenalidomide (n = 48) as maintenance in 71 newly diagnosed PCNSL patients in remission. Results With a median follow-up of 41.2 months, median overall survival (OS) and progression-free survival (PFS) remained unachieved for the total cohort. BTKi maintenance was associated with significantly superior PFS compared with lenalidomide (not achieved vs. 61.0 months; p = 0.016), with a substantially higher 6-year PFS rate (91.3% [95% CI: 69.5-97.7%] vs. 41.5% [95% CI: 23.8-58.4%], P < 0.001). This benefit was confirmed as an independent favourable prognostic factor in multivariate analysis (HR = 0.22, 95% CI: 0.05-0.87; P = 0.036). While PFS differed significantly, OS was comparable between the two groups. It is notable that 86.4% of patients who relapsed during lenalidomide maintenance transitioned to BTKi-based regimens, achieving a substantial second-line PFS (median 20.5 months). Furthermore, BTKi benefit was stable regardless of maintenance duration. In contrast, lenalidomide maintenance showed significant heterogeneity: optimal cutoffs for duration were identified separately for PFS (21.3 months) and OS (6.3 months). No treatment-related deaths occurred. Conclusion These data suggest that BTKi maintenance is a highly effective strategy for newly diagnosed PCNSL, offering prolonged progression-free survival compared with lenalidomide. The significant efficacy of BTKi in both first-line maintenance and second-line salvage settings provides a preliminary basis for re-evaluating current treatment paradigms, pending confirmation by prospective trials.
推荐引用方式
GB/T 7714：

Chang Xiaoli,He Zhangyuting,Wang Huanyuan, et al. Real-world comparison of BTK inhibitors and lenalidomide as first-line maintenance in primary CNS lymphoma: a multi-center retrospective study [J].JOURNAL OF NEURO-ONCOLOGY,2026,177(1).
APA：

Chang Xiaoli,He Zhangyuting,Wang Huanyuan,Zhu Huiying,&Sun Wanling.(2026).Real-world comparison of BTK inhibitors and lenalidomide as first-line maintenance in primary CNS lymphoma: a multi-center retrospective study .JOURNAL OF NEURO-ONCOLOGY,177(1).
MLA：

Chang Xiaoli, et al. "Real-world comparison of BTK inhibitors and lenalidomide as first-line maintenance in primary CNS lymphoma: a multi-center retrospective study" .JOURNAL OF NEURO-ONCOLOGY 177,1(2026).
入库时间：

2026/3/18 8:58:18
更新时间：

2026/3/18 8:58:18
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