Clinical Scenario

This protocol applies to patients with primary ovarian lymphoma in the setting of newly diagnosed primary central nervous system lymphoma (PCNSL) — a specific clinical context in which treatment selection must account for CNS involvement and patient fitness.

Treatment Approach

For fit patients, the approach centers on induction chemotherapy anchored by high-dose methotrexate alongside blood-brain barrier-penetrating cytotoxic agents, with regimen intensity and choice informed by transplant eligibility. Consolidation plays a central role in patients who achieve an adequate response to induction.

The complete regimen options, eligibility criteria, sequencing, and consolidation pathway are detailed in the full structured protocol below.

Treatment Goal

The aim of induction is to achieve responsive or stable disease — the prerequisite for proceeding to consolidation in eligible patients.

References

DOI: 10.1016/j.annonc.2025.07.014

For fit patients, induction ChT including HD-MTX is recommended at a minimum of 3 g/m² in a 2- to 4-h infusion [I, A].
HD-MTX alongside other blood–brain barrier-penetrating cytotoxics assessed in prospective trials are recommended [e.g. HD-MTX–cytarabine–thiotepa–R (MATRix), HD-MTX–procarbazine–vincristine (MPV) with or without R, HD-MTX–carmustine–etoposide–prednisone (MBVP) with or without R, R–MTX–temozolomide (R-MT)] [I, A; R is not EMA or FDA approved in this setting].
Thiotepa-based ASCT is recommended as consolidation therapy in fit patients with responsive or stable disease after suitable induction ChT [I, A].

View source ↗

Treatment of Primary Ovarian Lymphoma in Newly Diagnosed Primary Central Nervous System Lymphoma

Clinical Scenario

Treatment Approach

Treatment Goal

References