Intravenous high?dose methotrexate based systemic therapy in the treatment of isolated primary vitreoretinal lymphoma: An <scp>LOC</scp> network study

The treatment of primary vitreoretinal lymphoma (PVRL) remains controversial regarding the use local, systemic, or combined treatments. aim this study was to analyze efficacy and toxicity intravenous high-dose methotrexate (IV HD-MTX) based systemic therapy in a uniformly treated population PVRL patients. From nationwide French database, we retrospectively selected 59 patients (median age: 70 years, median Karnofsky Performance Status: 90%) with isolated at diagnosis who received first-line HD-MTX between 2011 2018. 8/59 also local treatment. No deaths premature discontinuations MTX due were reported. A complete response obtained 40/57 after chemotherapy. Before treatment, IL-10 elevated aqueous humor (AH) vitreous 89% After AH undetectable 87% CR/uCR/PR detectable 92% PD/SD. follow-up 61 months, 42/59 (71%) had relapsed, including 29 ocular relapses as first relapse total 22 brain relapses. overall survival, progression-free ocular-free survival brain-free 75, 18, 73 respectively. IV for is feasible, acceptable toxicity, even an elderly population. This strategy seems efficient prevent prolonged survival. However, rate high. New approaches are needed improve control disease, assessment could be completed by monitoring IL-10.