Dr Sumrall on the Current PCNSL Treatment Paradigm

“Our patients who are struggling with PCNSL are desperately in need of new treatments…Looking at the next-generation of BTK inhibitors is very encouraging for us.”

Ashley Sumrall, MD, FACP, FASCO, section chief of neuro-oncology at Atrium Health Levine Cancer Institute, discussed the role of CAR T-cell therapies and BTK inhibitors in the current primary central nervous system lymphoma (PCNSL) treatment paradigm, in addition to what’s to come in the field.

Sumrall began by discussing how new treatment options are necessary for patients with PCNSL, particularly for patients with recurrent disease, as their options are even more limited. Next-generation BTK inhibitors are a group of treatments that have generated of excitement for the PCNSL field, Sumrall said. She specifically underscored recent data for tirabrutinib (Velexbru) that has been encouraging for the PCNSL field; a new drug application for tirabrutinib was accepted by the FDA in February 2026. Sumrall emphasized that research and interest in new treatment options for PCNSL have ultimately been on the rise.

Sumrall also acknowledged the early stages of CAR T-cell therapy integration the PCNSL field is in. She specifically noted that the field is learning which patients with PCNSL respond well to CAR T-cell therapy as this modality is being integrated into the treatment paradigm. While the field still might be unsure as to why some subsets of patients respond better to CAR T-cell therapy than others, Sumrall mentioned research has focused on gathering better knowledge of which biomarkers are associated with different subsets of patients.

The nervous system involvement that comes with PCNSL presents a major challenge when trying to integrate CAR T-cell therapy into the treatment paradigm, she added. Sumrall highlighted how CAR T-cell therapies can have often have neurological adverse effects for patients and that exacerbated neurological toxicities must be closely monitored when treating PCNSL.