Dr. Bierman on Unmet Needs for Patients With CNS Involvement in Aggressive NHL

Philip Bierman, MD, professor, Internal Medicine, Division of Oncology & Hematology, University of Nebraska Medical Center, discusses unmet needs for patients with central nervous system (CNS) involvement in aggressive subtypes of non—Hodgkin lymphoma (NHL).

There are many unmet needs for patients with CNS involvement in aggressive subtypes of NHL, and there have not been any randomized trials to date for this population, explains Bierman. Therefore, the best regimen to use in these patients is still up for debate. Additionally, the use of transplant is another area of question, though many physicians tend to recommend the procedure, says Bierman.

As far as regimens are concerned, the combination of ibrutinib (Imbruvica) and R-CHOP or lenalidomide (Revlimid) and R-CHOP may decrease the rate of CNS relapse. As it stands, most physicians believe that some sort of anthracycline-based therapy in combination with mid-cycle high-dose methotrexate is a good regimen to pursue for these patients, states Bierman.