Efficacy and Safety of BTKis in Central Nervous System Lymphoma: A Systematic Review and Meta-Analysis

Yan Zhang; Jingjing Ye; Hao Chen; Daobin Zhou; Chunyan Ji

doi:10.3390/cancers16050860

Efficacy and Safety of BTKis in Central Nervous System Lymphoma: A Systematic Review and Meta-Analysis

Cancers (Basel). 2024 Feb 21;16(5):860. doi: 10.3390/cancers16050860.

Authors

Yan Zhang¹, Jingjing Ye², Hao Chen³, Daobin Zhou¹, Chunyan Ji²

Affiliations

¹ Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, China.
² Department of Hematology, Qilu Hospital of Shandong University, Jinan 250012, China.
³ College of Acupuncture and Chinese Tuina, Nanjing University of Chinese Medicine, Nanjing 210023, China.

Abstract

Background: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Bruton tyrosine kinase inhibitors (BTKis) for central nervous system lymphoma (CNSL).

Methods: A systematic review was carried out to identify relevant studies from the PubMed, Embase, Cochrane Library, Web of Science, WanFang, CNKI, and CBM databases. The studies included patients with CNSL who received BTKis and reported the overall response (OR), complete remission (CR), and partial response (PR). An overall effect analysis was performed using STATA 15.0. A random-effects model was utilized to calculate the pooled rates, and 95% confidence intervals (CI) were determined for all outcomes.

Results: A total of 21 studies involving 368 patients were included in the meta-analysis. For newly diagnosed CNSL, due to the small simple size, we conducted a quantitative description, and the ORR could reach up to 100%. For relapsed/refractory patients, the pooled ORR was 72% (95% CI: 64-80%, I² = 54.89%, p = 0.00), with a pooled CR and PR of 43% (95% CI: 33-54%, I² = 65.40%, p = 0.00) and 23% (95% CI: 13-35%, I² = 78.05%, p = 0.00), respectively. Most adverse events were hematology-related and generally manageable.

Conclusion: BTKis showed acceptable efficacy and safety in treating patients with CNSL. However, large and well-designed trials are still required to confirm BTKis as a treatment for CNSL.

Keywords: Bruton tyrosine kinase inhibitors; central nervous system lymphoma; efficacy; meta-analysis; safety.

Publication types

Review

Grants and funding

This research was funded by the National High Level Hospital Clinical Research Funding (2022-PUMCH-C-056, 2022-PUMCH-B-029), the CAMS Innovation Fund for Medical Sciences (CIFMS) (2021-I2M-1-041), the Distinguished Taishan Scholars Plan (NO. tspd20210321, NO. tstp20230653) and the horizontal subject of Shandong University (6010121004).