Evidence map›Paper›PMID 41189315›Full record

Trial reportNeuro-oncology2026

Multicenter randomized phase II study of R-MPV-A chemoimmunotherapy with or without low-dose whole-brain radiotherapy for newly-diagnosed primary CNS lymphoma.

Antonio Omuro, Lisa M DeAngelis, Mei-Yin C Polley, Denise Correa, Jeffrey S Wefel, Joseph A Bovi, Marc Rosenblum, Benjamin W Corn, Sanjay Aneja, Christian Grommes and 10 more

Abstract readClinical Trial, Phase IIRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Review
  3. Methodology of analysis of cognitive impairment in longitudinal randomized clinical trials in oncology: a scoping review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  4. Review
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Antonio OmuroDepartment of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA, USA (A.O.).ORCID 0000-0003-4299-3664
Lisa M DeAngelisDepartment of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, USA (L.M.D., D.C., M.R., C.G.).
Mei-Yin C PolleyNRG Oncology Statistics and Data Management Center, Chicago, IL, USA (M.-Y.C.P.).
Denise CorreaDepartment of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, USA (L.M.D., D.C., M.R., C.G.).
Jeffrey S WefelDepartment of Neurology, University of Texas MD Anderson Cancer Center, Houston, TX, USA (J.S.W.).
Joseph A BoviDepartment of Radiation Oncology, ThedaCare Regional Cancer Center, Appleton, WI, USA (J.A.B.).
Marc RosenblumDepartment of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, USA (L.M.D., D.C., M.R., C.G.).
Benjamin W CornDepartment of Oncology, Sha'are Zedek Medical Center, Jerusalem, Israel (B.W.C.).
Sanjay AnejaDepartment of Radiation Oncology, Yale University, New Haven, CT, USA (S.A.).
Christian GrommesDepartment of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, USA (L.M.D., D.C., M.R., C.G.).
David M PeereboomDepartment of Medicine, Cleveland Clinic, Cleveland, OH, USA (D.M.P.).
Enrico C LallanaDepartment of Neurology, Kaiser Permanente NCI Community Oncology Research Program, Oakland, CA, USA (E.C.L.).
Maria Werner-WasikDepartment of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA, USA (M.W.-W.).
C Leland RogersDepartment of Radiation Oncology, Utah Cancer Specialists, West Jordan, UT, USA (C.L.R.).
Fabio M IwamotoDepartment of Neurology, Columbia University Minority Underserved NCORP, Manhattan, NY, USA (F.M.I.).
Hsiang-Hsuan Michael YuDepartment of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA (H.-H.M.Y.).
Eric D DonnellyDepartment of Radiation Oncology, Northwestern University, Evanston, IL, USA (E.D.D.).
Timothy D StruveDepartment of Radiation Oncology, University of Cincinnati, Cincinnati, OH, USA (T.D.S.).
Minhee WonNRG Oncology Statistics and Data Management Center, Philadelphia, PA, USA (M.W.).
Minesh P MehtaDepartment of Radiation Oncology, Miami Cancer Institute, Miami, FL, USA (M.P.M.).ORCID 0000-0002-4812-5713

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
NRG Oncology Network Group Operations Center - GY9 BIQSFP Reports/BudgetsU10CA180868 · NCI · NRG ONCOLOGY FOUNDATION, INC. · PI NORMAN WOLMARK · 2014 to 2026
$206.8M
Statistics CoreU10CA180822 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI James J. Dignam · 2014 to 2026
$146.4M
National Institute of Health U10CA180822National Institute of Health U10CA180868NCI NIH HHS P30 CA008748NCI NIH HHS U10 CA180822NCI NIH HHS U10 CA180868
6 · The paper itself

Abstract

backgroundMethotrexate-based chemoradiotherapy is effective in primary central nervous system lymphoma (PCNSL) but carries a risk of severe neurotoxicity. In a single-arm study, a regimen with methotrexate, procarbazine, vincristine, and cytarabine was combined with rituximab (R-MPV-A) and substantially reduced doses of whole-brain radiotherapy (LD-WBRT), resulting in excellent progression-free survival (PFS) and overall survival (OS). Because R-MPV-A had never been tested without radiation, we sought to evaluate the efficacy of R-MPV-A with and without LD-WBRT, as well as determining if such low radiotherapy doses influenced disease control and/or neurotoxicity.

methodsPatients were randomized to receive R-MPV-A alone (Chemo arm) or combined with LD-WBRT (ChemoRT arm), given at 2,340 cGy (180cGy X13). Primary endpoint was intent-to-treat (ITT) PFS. A sample size of 89 would provide 80% power to detect a hazard ratio (HR) of 0.63 (one-sided alpha = 0.15).

resultsNinety-one patients were randomized, with 44 analyzed in the ChemoRT and 46 in the Chemo arm. Median age was 66 and 59.5, respectively. R-MPV-A was well tolerated, achieving a complete response rate of 92.3% (ChemoRT) and 76.3% (Chemo). After median follow-up of 4.6 years, median PFS was not reached (ChemoRT) vs 2.1 years (Chemo), HR = 0.47 (P = .007; 95% CI, 0.26-0.87). The 2-year PFS was 78.7% vs 54%, respectively. Differences in OS did not reach statistical significance (HR = 0.71; P = .33). Neuropsychological evaluation showed no differences in cognitive outcomes, with several tests favoring ChemoRT.

conclusionsR-MPV-A is a highly efficacious and safe regimen with or without LD-WBRT. LD-WBRT contributes to disease control and increases PFS in PCNSL.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCentral Nervous System NeoplasmsChemoradiotherapyCranial IrradiationImmunotherapyLymphomaAdultAgedCytarabineFemaleFollow-Up StudiesHumansMaleMethotrexateMiddle AgedProcarbazineCytarabineMethotrexateProcarbazineRituximabVincristinebrain neoplasmchemotherapyclinical trialprimary central nervous system lymphomaradiotherapy

Identifiers

PMID41189315
PMCPMC12904153

What Socratic holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.