OnCo

Primary CNS lymphoma: lines of therapy

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3 standard-of-care settings across 3 lines and 3 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineFitFRαUnfit / older
Advanced, first line1··
Third line and beyond·1·
Special situations··1

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
FitNewly diagnosed, fit (<65-70)Rituximab + high-dose methotrexate + cytarabine ± thiotepa (MATRix) ×4, then high-dose thiotepa-based chemotherapy with autologous transplant (IELSG32, IELSG43).83

Third line and beyond

SubgroupSettingApproachProducts and trialsEvidence
FRαRelapsed/refractoryRe-induction with methotrexate if durable first remission; ibrutinib, lenalidomide-rituximab, high-dose chemotherapy/ASCT if not done, WBRT; CD19 CAR-T and PD-1 inhibitors in trials or off-label.87

Special situations

SubgroupSettingApproachProducts and trialsEvidence
Unfit / olderNewly diagnosed, older/unfitHigh-dose methotrexate with temozolomide, procarbazine or rituximab (e.g. MT-R, R-MP), then maintenance (temozolomide, lenalidomide) or reduced-dose WBRT; ibrutinib-based induction in trials.87

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.