Houillier C, et al. - Whether chemoimmunotherapy followed by either whole-brain radiotherapy (WBRT) or intensive chemotherapy and autologous stem-cell transplantation (ASCT) would be an efficacious and safe option for the first-line treatment of primary CNS lymphoma (PCNSL) was investigated in this study with 140 immunocompetent patients (18 to 60 years of age) with untreated PCNSL recruited from 23 French centers. After induction chemotherapy with two cycles of R-MBVP (rituximab 375 mg/m2 day (D) 1, methotrexate 3 g/m2 D1; D15, VP16 100 mg/m2 D2, BCNU 100 mg/m2 D3, prednisone 60 mg/kg/d D1-D5) followed by two cycles of R-AraC (rituximab 375 mg/m2 D1, cytarabine 3 g/m2 D1 to D2), participants randomly received WBRT or ASCT as consolidation treatment. They assessed 2-year progression-free survival (primary end point) as well as cognitive outcome (secondary end point). In the WBRT and ASCT arms, 2-year progression-free survival rates of 63% and 87%, respectively, were noted. WBRT led to cognitive impairment; ASCT was associated with preserved or improved cognitive functions. Overall, findings revealed the effectiveness of WBRT and ASCT as consolidation treatments for patients with PCNSL who were 60 years of age and younger. The ASCT arm was favored in terms of efficacy end points.