Sieg N, Naendrup JH, Gödel P, et al. - Researchers analyzed results of patients with newly diagnosed primary central nervous system lymphoma managed with different strategies in clinical routine. They analyzed 100 patients, with 23-88 years of age, who were either managed with methotrexate (MTX)-based regimens (PRIMAIN, MARTA, MATRix), individual regimens, or best supportive care, respectively. Generally high overall response rates (66,7-83,8%) were obtained, however, different organ toxicities needed dose adjustments in most groups. The estimated 2-year overall survival rates were 57,9% (PRIMAIN), 63,6% (MARTA), 65,4% (MATRix), and 37,5% (Other), respectively. Findings demonstrate that different MTX-based treatment strategies are feasible in clinical routine, although a relevant proportion of patients were not eligible for clinical trials because of age, performance status, or comorbidities. Surprisingly favorable results were seen even in elderly patients. However, with compromising organ toxicities, attenuation of intensity is advised to be a component of strategies in future clinical trials.