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J Clin Oncol. 2007 Apr 10;25(11):1350-6. Epub 2007 Feb 20.

Phase I study of intraventricular administration of rituximab in patients with recurrent CNS and intraocular lymphoma.

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  • 1Division of Hematology/Oncology, and the Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94143, USA. jamesr@medicine.ucsf.edu

Abstract

PURPOSE:

We previously determined that intravenous administration of rituximab results in limited penetration of this agent into the leptomeningeal space. Systemic rituximab does not reduce the risk of CNS relapse or dissemination in patients with large cell lymphoma. We therefore conducted a phase I dose-escalation study of intrathecal rituximab monotherapy in patients with recurrent CNS non-Hodgkin's lymphoma (NHL).

PATIENTS AND METHODS:

The protocol planned nine injections of rituximab (10 mg, 25 mg, or 50 mg dose levels) through an Ommaya reservoir over 5 weeks. The safety profile of intraventricular rituximab was defined in 10 patients.

RESULTS:

The maximum tolerated dose was determined to be 25 mg and rapid craniospinal axis distribution was demonstrated. Cytologic responses were detected in six patients; four patients exhibited complete response. Two patients experienced improvement in intraocular NHL and one exhibited resolution of parenchymal NHL. High RNA levels of Pim-2 and FoxP1 in meningeal lymphoma cells were associated with disease refractory to rituximab monotherapy.

CONCLUSION:

These results suggest that intrathecal rituximab (10 to 25 mg) is feasible and effective in NHL involving the CNS.

PMID:
17312328
[PubMed - indexed for MEDLINE]
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