Peripheral T-cell lymphoma – are we making progress?

Khan, Niloufer; Özkaya, Neval; Moskowitz, Alison J.; Doğan, Ahmet; Horwitz, Steven M.

doi:10.1016/j.beha.2018.07.010

“…Peripheral T-cell lymphoma is a heterogeneous group of aggressive lymphomas with a poor OR rate and shorter PFS than B-cell lymphoma. Peripheral T-cell lymphomas include angioimmunoblastic T-cell lymphoma, anaplastic large cell lymphomas, peripheral T-cell lymphoma, not otherwise specified, and intestinal T-cell lymphomas [ 156 ]. In these disorders, bortezomib can be considered as therapy for refractory or relapsed disease [ 157 ].…”

Section: T-cell Lymphomasmentioning

confidence: 99%

Bortezomib for the Treatment of Hematologic Malignancies: 15 Years Later

Robak

¹

,

Robak

²

2019

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Bortezomib is a dipeptidyl boronic acid that selectively inhibits the ubiquitin proteasome pathway, which plays a role in the degradation of many intracellular proteins. It is the first-in-class selective and reversible inhibitor of the 26S proteasome, with antiproliferative and antitumor activity. It exerts its anti-neoplastic action mainly via the inhibition of the nuclear factor-κB pathway components associated with cell proliferation, apoptosis, and angiogenesis. The drug has revolutionized the treatment of multiple myeloma and, more recently, mantle cell lymphoma. In 2003, bortezomib received accelerated approval from the US Food and Drug Administration for the treatment of relapsed/refractory multiple myeloma and in 2008 for patients with previously untreated multiple myeloma. In 2006, bortezomib was approved for the treatment of refractory/relapsed mantle cell lymphoma and, in 2014, for previously untreated mantle cell lymphoma. Bortezomib has also demonstrated clinical efficacy both as a single drug and in combination with other agents in light chain amyloidosis, lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia, and peripheral T-cell lymphomas. Furthermore, continued clinical studies are required to confirm its value for patients with indolent and aggressive B-cell non-Hodgkin lymphomas and acute leukemias.

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“…The therapeutic effect of a single agent or its combination with the GDP program needs further investigation. [38][39][40] Molecular biologic classification technique (MICM) typing can guide the selection of targeted drugs, which improves patient response rates. In the future, increased study of the genetic mutations in lymphoma patients is needed to guide clinical treatment.…”

Section: Toxicity Grade 3/4 Myelosuppressionmentioning

confidence: 99%

Outcomes of GDPT (gemcitabine, cisplatin, prednisone, thalidomide) versus CHOP in newly diagnosed peripheral T-cell lymphoma patients

Sun

¹

,

Li

²

,

Li

³

et al. 2020

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Aim: To compare the outcomes of GDPT [gemcitabine (G), cisplatin (D), prednisone (P), thalidomide (T)] versus CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) in treating newly diagnosed PTCL (peripheral T-cell lymphoma). Methods: An open-label prospective clinical trial with 153 newly diagnosed PTCL patients conducted between January 2010 and December 2018 was designed. Patients were randomly assigned to the GDPT (77 cases) and CHOP (76 cases) groups. Patients in each group were further divided into four subgroups: PTCL, not otherwise specified (PTCL-NOS); anaplastic large cell lymphoma (ALCL), angioimmunoblastic T cell lymphoma (AITL), and other types subgroup, in accordance with pathological patterns. Based on expression of RRM1, TOP2A, TUBB3, and ERCC1, patients were divided into groups with high and low gene expression levels. Clinical characteristics, side effects, efficacy, progression-free survival (PFS), and overall survival (OS) were compared. Results: There were no significant differences in the basic clinical features or side effects between the GDPT and CHOP groups. The overall response rate (ORR) of the GDPT group was better than that of the CHOP group (66.3% versus 50.0%, p = 0.042), as was the complete remission (CR) rate (42.9% versus 27.6%, p = 0.049). Patients in the GDPT group had a longer PFS and OS than the CHOP group. The 4-year PFS and OS rates in the GDPT group were both superior to those in the CHOP group (63.6% versus 53.0% for PFS, p = 0.035; 66.8% versus 53.6% for OS, p = 0.039). In the GDPT group, the difference in CR between the four subgroups was statistically significant ( p = 0.046). In the CHOP group, differences in both CR and ORR among the four subgroups were statistically significant ( p < 0.001 and p = 0.005, respectively). There were also statistically significant differences in CR between patients treated with CHOP and GDPT in the PTCL-NOS subgroup, AITL subgroup, and the other types subgroup ( p = 0.015; p = 0.003; p = 0.005, respectively). The data also showed a significant difference in OS among the four subgroups within the GDPT group ( p = 0.001). The OS of AITL was shorter than that of the other three subgroups. Four subgroups of CHOP showed a significant difference in PFS ( p = 0.019). There was no statistical association between responses and the gene expression levels of RRM1, ERCC1, TUBB3, and TOP2A. Conclusion: The GDPT group had better response rates and prolonged patient PFS and OS. As a promising new regimen, GDPT is expected to become the first-line therapy for PTCL. New agents should be applied to patients who do not achieve good responses with previous treatment, such as those diagnosed with angioimmunoblastic T cell lymphoma. Trial registration: This open randomized prospective clinical trial was registered at ClinicalTrials.gov (NCT01664975).

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“…Peripheral T-cell lymphoma (PTCL) is a relatively rare T-cell non-Hodgkin lymphoma. Several PTCL subtypes include PTCL,not otherwise specified (PTCL-NOS), angioimmunoblastic T-cell lymphoma (AITL), and anaplastic large cell lymphoma (ALCL) [ 1 , 2 ]. It is worth mentioning that PTCL-NOS is the mostly broad category of PTCL.…”

Section: Introductionmentioning

confidence: 99%

The role of pre-treatment and mid-treatment 18F-FDG PET/CT imaging in evaluating prognosis of peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS)

Zhang

¹

,

Wang

²

,

Zhao

³

et al. 2021

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Background It has been reported the prognostic value of MTV in predicting the disease prognosis of peripheral T-cell lymphoma (PTCL) through pre-treatment PET/CT imaging. However, these are limited data on pretreatment evaluation and prognosis assessments of peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS). This study aimed to determine the prognostic values of pre-treatment and mid-treatment total metabolic tumor volume (MTV), total lesion glycolysis (TLG), and Deauville 5-Point Scale (D-5PS) in accessing the prognosis of PTCL-NOS. Methods A retrospective analysis was conducted in 31 patients with pathologically diagnosed PTCL-NOS. These patients have undergone positron emission PET/CT scanning before and during chemotherapy. Follow-ups were also done to investigate the 2-year progression-free survival (PFS) and Overall Survival (OS) of these patients. During $${}^{18}$$ 18 F-fluorodeoxyglucose ($${}^{18}$$ 18 F-FDG) PET/CT scans, the MTV and TLG were recorded. Meanwhile, $$\bigtriangleup$$ △ MTV and $$\bigtriangleup$$ △ TLG were calculated. Furthermore, the receiver operating characteristic (ROC) curve was employed to classify and to define the threshold values. On the other hand, the mid-chemotherapy assessment and staging of these 31 patients were done by utilizing D-5PS. Subsequently, based on the D-5PS scores obtained, these patients were grouped into two categories: a group of patients with a score of <4 and another group with $$\ge$$ ≥ 4 points. For these two groups of patients, the survival analysis was done by Kaplan–Meier analysis and a multivariate COX regression model. Moreover, Pearson’s chi-square test ($$\chi ^{2}$$ χ 2 test) and Spearman rank correlation coefficient were used to comparing the collected data, respectively. Results During the 2-year follow-up period, 15 out of the 31 patients experienced disease progression. The optimal threshold values for both baseline MTV and TLG were 158.16 cm$$^{3}$$ 3 and 677.40.Additionally, the difference in 2-year PFS between the progressive and non-progressive groups was statistically significant ($$\chi ^{2}=8.193$$ χ 2 = 8.193 , $$P=0.004<0.05$$ P = 0.004 < 0.05 ; $$\chi ^{2}=8.872$$ χ 2 = 8.872 , $$P=0.003<0.05$$ P = 0.003 < 0.05 ), significant between-group difference was detected for MTV and for TLG ($$\chi ^{2}=6.494$$ χ 2 = 6.494 , $$P=0.011<0.05$$ P = 0.011 < 0.05 ; $$\chi ^{2}=4.687$$ χ 2 = 4.687 , $$P=0.03<0.05$$ P = 0.03 < 0.05 ). On the other hand, when these patients were classified into two groups according to the mid-chemotherapy Deauville score of <4 and $$\ge$$ ≥ 4, the statistical difference of 2-year PFS between these two groups was significant, too ($$\chi ^{2}=14.966$$ χ 2 = 14.966 , $$P=0.001<0.05$$ P = 0.001 < 0.05 ),but there is no significant between-group difference in OS ($$\chi ^{2}=3.337$$ χ 2 = 3.337 , $$P=0.068<0.05$$ P = 0.068 < 0.05 ). COX analysis revealed that D-5PS are the independent factors influencing PFS, while MTV is the independent influencing factor of OS. Conclusion The baseline total MTV obtained by PET/CT scanning, and D-5PS are crucial prognostic factors in evaluating the prognosis of PTCL-NOS.

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Peripheral T-cell lymphoma – are we making progress?

Cited by 10 publications

References 60 publications

Bortezomib for the Treatment of Hematologic Malignancies: 15 Years Later

Bortezomib for the Treatment of Hematologic Malignancies: 15 Years Later

Outcomes of GDPT (gemcitabine, cisplatin, prednisone, thalidomide) versus CHOP in newly diagnosed peripheral T-cell lymphoma patients

The role of pre-treatment and mid-treatment 18F-FDG PET/CT imaging in evaluating prognosis of peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS)

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