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Abstract Details

Performance Status and Clinical Outcomes in Primary Central Nervous System Lymphoma Patients Treated With Ibrutinib
Neuro-oncology
P4 - Poster Session 4 (8:00 AM-9:00 AM)
6-005

To describe the association between performance status, clinical response, and overall survival (OS) in primary central nervous system lymphoma (PCNSL) patients treated with Ibrutinib.
PCNSL is a non-Hodgkin lymphoma that infiltrates the brain, spinal cord, or eyes. Despite existing first-line therapy, most patients will experience relapsed or refractory (R/R) disease. Second-line treatment for R/R disease is currently not standardized. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, has shown promise and is increasingly used to manage B-cell neoplasms, including PCNSL.
A retrospective cohort study was performed on patients with pathology-confirmed PCNSL treated with Ibrutinib at a tertiary care center between 2000 and 2025. Patients were stratified based on Karnofsky Performance Score (KPS) at the time of Ibrutinib induction (KPS ≤60 vs >60). Patients were also stratified into three Ibrutinib response groups: responders (radiographic remission or maintenance), clinically stable non-responders (CSNRs; no radiographic improvement but stable performance status for ≥6 months), and non-responders (radiographic and clinical decline within 6 months). OS was analyzed using the Kaplan-Meier (KM) method for survival.
32 patients (mean age: 63.2, range: 28-84) were identified. A KM analysis displayed that patients with a KPS of ≤60 (N=10) trended towards worse OS, compared to patients with a KPS of >60 (N=21; p=0.224). Responders (N=8) had an unreached KM median OS and significantly outlived CSNRs (N=9; p=0.048) and non-responders (N=10; p=0.001). CSNRs had a median OS of 481 days and significantly outlived non-responders (p=0.037). Non-responders had a median OS of 55 days.
Lower baseline KPS demonstrated a trend toward worse OS, suggesting a prognostic value of baseline functional status. Response to Ibrutinib was significantly associated with OS, indicating that attaining clinical stability can offer OS benefit, even without radiographic remission. Given the small sample size of the study, further investigation is essential to establish the role of Ibrutinib in PCNSL management.
Authors/Disclosures
Sayujya Timilsena
PRESENTER 		Mr. Timilsena has nothing to disclose.
Jerome J. Graber, MD, MPH, FAAN (University of Washington) Dr. Graber has received personal compensation for serving as an employee of Binaytara Foundation. Dr. Graber has received personal compensation in the range of $500-$4,999 for serving as a Consultant for 好色先生. Dr. Graber has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Dickie McCamey Attorneys at Law. Dr. Graber has a non-compensated relationship as a Editorial Board member with Neuro-Oncology: Practice, published by Oxford that is relevant to AAN interests or activities. Dr. Graber has a non-compensated relationship as a Editorial Board Member with Journal of Pain and Symptom Management that is relevant to AAN interests or activities. Dr. Graber has a non-compensated relationship as a Board of Directors with American Society of Neuroimaging that is relevant to AAN interests or activities. Dr. Graber has a non-compensated relationship as a Board of Directors and Certification Exam Committee Member with United Council of Neurological Subspecialties that is relevant to AAN interests or activities. Dr. Graber has a non-compensated relationship as a Question of the Day 'app' committee and NeuroSAE and Continuum with 好色先生 that is relevant to AAN interests or activities. Dr. Graber has a non-compensated relationship as a Editorial Board Member with Practical Neurology (BMC) that is relevant to AAN interests or activities.
Lynne P. Taylor, MD, FAAN (University of Washington) Dr. Taylor has received publishing royalties from a publication relating to health care.
Vyshak Venur (University of Washington) No disclosure on file