PCNSL in primary vitreoretinal lymphoma: first-line approach for patients with comorbidities or contraindications to chemotherapy

Clinical scenario

This protocol addresses primary central nervous system lymphoma in patients whose disease is limited to the eye — primary vitreoretinal lymphoma — and who present with relevant comorbidities, poor clinical condition, or contraindications to standard chemotherapy.

Patient population

        Disease is confined to the vitreoretinal compartment. These patients are considered unfit for or have contraindications to chemotherapy, determined at the discretion of the treating clinician based on clinical condition and comorbidity burden.
      

First-line approach

In this setting, first-line management may draw on oral alkylating agents or local ocular therapies — the specific options, their selection criteria, and how they are applied are detailed in the full structured protocol.

Complete regimen, dosing guidance, and evidence summary available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

Patients with relevant comorbidities or poor clinical condition at the discretion of the clinician.

Oral alkylating agents [i.e. temozolomide (not EMA approved, not FDA approved)] and local therapies (ocular RT or intravitreal MTX injection) are acceptable options as first-line treatment for unfit patients or patients with contraindications to ChT.

DOI: 10.1016/j.annonc.2023.11.010

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