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IBER is a combination salvage chemotherapy regimen consisting of the Bruton's tyrosine kinase (BTK) inhibitor ibrutinib, the alkylating agent ifosfamide, the topoisomerase II inhibitor etoposide, and the anti-CD20 monoclonal antibody rituximab. This regimen is specifically designed for the treatment of relapsed or refractory primary central nervous system lymphoma (PCNSL), particularly in patients who are ineligible for autologous stem cell transplantation. The combination leverages the ability of ibrutinib and certain chemotherapeutic agents to penetrate the blood-brain barrier to maximize anti-lymphoma activity within the central nervous system. In clinical protocols led by Deok-Hwan Yang, the IBER induction phase (up to 6 cycles) is typically followed by a maintenance phase of ibrutinib monotherapy for a fixed duration (up to 6 months) to prolong remission and evaluate safety in this high-risk population.
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