Clinical Outcomes of CNS Lymphoma Treated with Ibrutinib-Based Therapy: A Real-Life Multicenter Experience on Off-Label Use of Ibrutinib

Despite recent therapeutic advances, the prognosis of patients with relapsed/refractory (RR) primary (PCNSL) and secondary central nervous system lymphoma (SCNSL) remains poor. Therefore, the need for new treatment options in CNSL continues. Ibrutinib has been used in clinical trials for CNSL in recent years. However, there is no real -life data on this subject yet. We retrospectively evaluated the efficacy of ibrutinib alone or in combination with various treatment options in 39 patients, 21 with PCNSL and 18 with SCNSL. The median age was 62 years and the overall response rate (ORR) was 59%. The median overall survival (OS) was four months for all patients and 13 months for responder patients (p< 0.001). Invasive aspergillosis occurred in 10.2% of the patients. Lactate dehy- drogenase activity, response to treatment, and the presence of the invasive fungal infection were prognostic factors affecting OS on the ibrutinib therapy (p= 0.04, p= 0.02, and p= 0.048, respectively). There was no significant difference in prognosis between the IBR monotherapy and IBR combination groups. Compared to early -phase clinical studies, lower ORR, shorter OS, and a higher incidence of invasive fungal infections were observed in this real -life study of ibrutinib which was used alone or in a combination regimen in patients with RR PCNSL and SCNSL.