The management of primary central nervous system (PCNSL) is one of the most controversial topics in neuro-oncology because of the complexity of the disease and the limited number of controlled studies available. In 2021, given recent advances and publication of practice-changing randomised trials, the European Association of Neuro-Oncology (EANO) created a multidisciplinary task force to update the previously published evidence-based guidelines for immunocompetent adult patients with PCNSL and added a section on immunosuppressed patients. The guideline provides consensus considerations and recommendations for treatment of PCNSL, including intraocular manifestations and specific management of elderly . The main changes from the previous guideline include strenghtened evidence for the consolidation with ASCT in first-line treatment, prospectively assessed chemotherapy combinations for both young and elderly patients, clarification of the role of rituximab even though the data remain inconclusive, of the role of new agents, and the incorporation of immunosuppressed patients and primary ocular lymphoma. The guideline should aid the clinicians in everyday practice and decision making and serve as a basis for future research in the field.
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Khê Hoang-Xuan, Martina Deckert, Andrés J M Ferreri, Julia Furtner, Jaime Gallego Perez-Larraya, Roger Henriksson, Andreas F Hottinger, Benjamin Kasenda, Florence Lefranc, Alexander Lossos, Catherine McBain, Matthias Preusser, Patrick Roth, Roberta Rudà, Uwe Schlegel, Riccardo Soffietti, Carole Soussain, Martin J B Taphoorn, Valérie Touitou, Michael Weller, Jacoline E C Bromberg, European Association of Neuro-Oncology (EANO) Guidelines for Treatment of Primary Central Nervous System lymphoma (PCNSL), Neuro-Oncology, 2022; doi.org/10.1093/neuonc/noac196