Skip to main content
Erschienen in: Current Oncology Reports 7/2023

12.04.2023

First-Line Therapy for Nodal T-cell Non-Hodgkin Lymphomas: an Unmet Need in Hematology

verfasst von: Vibor Milunović, Inga Mandac Smoljanović, Martina Bogeljić Patekar, Viktor Zatezalo, Marin Kursar, Delfa Radić-Krišto, Slobodanka Ostojić Kolonić, Slavko Gašparov

Erschienen in: Current Oncology Reports | Ausgabe 7/2023

Einloggen, um Zugang zu erhalten

Abstract

Purposeof Review

The main aim of this review is to summarize first-line therapy of nodal T-cell non-Hodgkin lymphoma.

Recent Findings

Current treatment with CHOP chemotherapy results in poor outcomes in the majority of patients. However, there are advances within the field. First breakthrough is the ECHELON-2 trial which showed that the addition of brentuximab vedotin improves outcomes in anaplastic large cell lymphoma. However, other types of peripheral T-cell non-Hodgkin lymphoma were underrepresented with optimal treatment not known. Second breakthrough is an increase of autologous stem cell transplantation usage in the first complete metabolic remission, except in ALK + anaplastic large cell lymphoma, offering better disease control.

Summary

Despite advances in the field, CHOP remains the standard treatment for the majority of these lymphomas, but multiple trials are underway with the aim to improve this unmet need in hematology and, hopefully, leading us to a new era in the treatment of peripheral T-cell lymphomas.
Literatur
7.
Zurück zum Zitat Jaffe ES, Harris NL, Stein H, et al editors. World Health Organization Classification of Tumors: pathology and genetics of tumors of hematopoietic and lymphoid tissues. Lyon: France, IARC Press; 2001. Jaffe ES, Harris NL, Stein H, et al editors. World Health Organization Classification of Tumors: pathology and genetics of tumors of hematopoietic and lymphoid tissues. Lyon: France, IARC Press; 2001.
10.
Zurück zum Zitat Savage KJ, Harris NL, Vose JM, Ullrich F, Jaffe ES, Connors JM, et al. ALK- anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-Cell Lymphoma Project. Blood. 2008;111:5496–504. https://doi.org/10.1182/blood-20pi8-01-134270.CrossRefPubMed Savage KJ, Harris NL, Vose JM, Ullrich F, Jaffe ES, Connors JM, et al. ALK- anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-Cell Lymphoma Project. Blood. 2008;111:5496–504. https://​doi.​org/​10.​1182/​blood-20pi8-01-134270.CrossRefPubMed
14.
Zurück zum Zitat •• Horwitz SM, Ansell S, Ai WZ, Barnes J, Barta SK, Brammer J, et al. T-Cell Lymphomas, Version 2.2022, NCCN Clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2022;20:285–308. https://doi.org/10.6004/jnccn.2022.0015Usually precise, these guidelines are vague in terms of treatment of T-cell lymphoma.CrossRefPubMed •• Horwitz SM, Ansell S, Ai WZ, Barnes J, Barta SK, Brammer J, et al. T-Cell Lymphomas, Version 2.2022, NCCN Clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2022;20:285–308. https://​doi.​org/​10.​6004/​jnccn.​2022.​0015Usually precise, these guidelines are vague in terms of treatment of T-cell lymphoma.CrossRefPubMed
21.
Zurück zum Zitat Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J. Lymphoma classification–from controversy to consensus: the R.E.A.L. and WHO Classification of lymphoid neoplasms. Ann Oncol. 2000;11:3–10.CrossRefPubMed Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J. Lymphoma classification–from controversy to consensus: the R.E.A.L. and WHO Classification of lymphoid neoplasms. Ann Oncol. 2000;11:3–10.CrossRefPubMed
25.
Zurück zum Zitat Fossard G, Broussais F, Coelho I, Bailly S, Nicolas-Virelizier E, Toussaint E, et al. Role of up-front autologous stem-cell transplantation in peripheral T-cell lymphoma for patients in response after induction: an analysis of patients from LYSA centers. Ann Oncol. 2018;29:715–23. https://doi.org/10.1093/annonc/mdx787. Fossard G, Broussais F, Coelho I, Bailly S, Nicolas-Virelizier E, Toussaint E, et al. Role of up-front autologous stem-cell transplantation in peripheral T-cell lymphoma for patients in response after induction: an analysis of patients from LYSA centers. Ann Oncol. 2018;29:715–23. https://​doi.​org/​10.​1093/​annonc/​mdx787.
26.
Zurück zum Zitat Park SI, Horwitz SM, Foss FM, Pinter-Brown LC, Carson KR, Rosen ST et al. The role of autologous stem cell transplantation in patients with nodal peripheral T-cell lymphomas in first complete remission: Report from COMPLETE, a prospective, multicenter cohort study. Cancer. 2019;125:1507–1517. https://doi.org/10.1002/cncr.31861 Park SI, Horwitz SM, Foss FM, Pinter-Brown LC, Carson KR, Rosen ST et al. The role of autologous stem cell transplantation in patients with nodal peripheral T-cell lymphomas in first complete remission: Report from COMPLETE, a prospective, multicenter cohort study. Cancer. 2019;125:1507–1517. https://​doi.​org/​10.​1002/​cncr.​31861
27.
Zurück zum Zitat El-Asmar J, Reljic T, Ayala E, Hamadani M, Nishihori T, Kumar A, et al. Efficacy of high-dose therapy and autologous hematopoietic cell transplantation in peripheral T cell lymphomas as front-line consolidation or in the relapsed/refractory setting: a systematic review/meta-analysis. Biol Blood Marrow Transplant. 2016;22:802–14. https://doi.org/10.1016/j.bbmt.2015.12.004.CrossRefPubMed El-Asmar J, Reljic T, Ayala E, Hamadani M, Nishihori T, Kumar A, et al. Efficacy of high-dose therapy and autologous hematopoietic cell transplantation in peripheral T cell lymphomas as front-line consolidation or in the relapsed/refractory setting: a systematic review/meta-analysis. Biol Blood Marrow Transplant. 2016;22:802–14. https://​doi.​org/​10.​1016/​j.​bbmt.​2015.​12.​004.CrossRefPubMed
28.
Zurück zum Zitat •• Fox CP, Ahearne MJ, Pettengell R, Dearden C, El-Sharkawi D, Kassam S, et al. Guidelines for the management of mature T- and natural killer-cell lymphomas (excluding cutaneous T-cell lymphoma): a British Society for Haematology Guideline. Br J Haematol. 2022;196:507–22. https://doi.org/10.1111/bjh.17951. The precise guidelines using the GRADE system as the most thorough guidelines in T-cell lymphoma.CrossRefPubMed •• Fox CP, Ahearne MJ, Pettengell R, Dearden C, El-Sharkawi D, Kassam S, et al. Guidelines for the management of mature T- and natural killer-cell lymphomas (excluding cutaneous T-cell lymphoma): a British Society for Haematology Guideline. Br J Haematol. 2022;196:507–22. https://​doi.​org/​10.​1111/​bjh.​17951. The precise guidelines using the GRADE system as the most thorough guidelines in T-cell lymphoma.CrossRefPubMed
29.
Zurück zum Zitat El-Asmar J, Reljic T, Ayala E, Hamadani M, Nishihori T, Kumar A, et al. Efficacy of high-dose therapy and autologous hematopoietic cell transplantation in peripheral T cell lymphomas as front-line consolidation or in the relapsed/refractory setting: a systematic review/meta-analysis. Biol Blood Marrow Transplant. 2016;22:802–14. El-Asmar J, Reljic T, Ayala E, Hamadani M, Nishihori T, Kumar A, et al. Efficacy of high-dose therapy and autologous hematopoietic cell transplantation in peripheral T cell lymphomas as front-line consolidation or in the relapsed/refractory setting: a systematic review/meta-analysis. Biol Blood Marrow Transplant. 2016;22:802–14.
30.
Zurück zum Zitat • Schmitz N, Truemper L, Bouabdallah K, Ziepert M, Leclerc M, Cartron G, et al. A randomized phase 3 trial of autologous vs allogeneic transplantation as part of first-line therapy in poor-risk peripheral T-NHL. Blood. 2021;137:2646–56. Proof-of-concept study on the role of autologous and allogeneic stem cell transplantation in peripheral T-cell lymphoma.PubMedPubMedCentral • Schmitz N, Truemper L, Bouabdallah K, Ziepert M, Leclerc M, Cartron G, et al. A randomized phase 3 trial of autologous vs allogeneic transplantation as part of first-line therapy in poor-risk peripheral T-NHL. Blood. 2021;137:2646–56. Proof-of-concept study on the role of autologous and allogeneic stem cell transplantation in peripheral T-cell lymphoma.PubMedPubMedCentral
32.
Zurück zum Zitat • Wulf GG, Altmann B, Ziepert M, D’Amore F, Held G, Greil R, et al. Alemtuzumab plus CHOP versus CHOP in elderly patients with peripheral T-cell lymphoma: the DSHNHL2006-1B/ACT-2 trial. Leukemia. 2021;35:143–55. https://doi.org/10.1038/s41375-020-0838-5. Example how addition of drug X to CHOP backbone is in majority of trials futile in this area. • Wulf GG, Altmann B, Ziepert M, D’Amore F, Held G, Greil R, et al. Alemtuzumab plus CHOP versus CHOP in elderly patients with peripheral T-cell lymphoma: the DSHNHL2006-1B/ACT-2 trial. Leukemia. 2021;35:143–55. https://​doi.​org/​10.​1038/​s41375-020-0838-5Example how addition of drug X to CHOP backbone is in majority of trials futile in this area.
36.
Zurück zum Zitat •• Horwitz S, O’Connor OA, Pro B, Illidge T, Fanale M, Advani R, et al. Brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma (ECHELON-2): a global, double-blind, randomised, phase 3 trial. Lancet. 2019;393:229–40. https://doi.org/10.1016/S0140-6736(18)32984-2. A breakthrough trial in ALCLs showing that addition of brentuximab vedotin to CHP backbone improves the outcomes; however, other histologies are underrepresented leaving the optimal therapy unknown.CrossRefPubMed •• Horwitz S, O’Connor OA, Pro B, Illidge T, Fanale M, Advani R, et al. Brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma (ECHELON-2): a global, double-blind, randomised, phase 3 trial. Lancet. 2019;393:229–40. https://​doi.​org/​10.​1016/​S0140-6736(18)32984-2A breakthrough trial in ALCLs showing that addition of brentuximab vedotin to CHP backbone improves the outcomes; however, other histologies are underrepresented leaving the optimal therapy unknown.CrossRefPubMed
38.
Zurück zum Zitat Horwitz S, O’Connor OA, Pro B, Trümper L, Iyer S, Advani R, et al. The ECHELON-2 Trial: 5-year results of a randomized, phase III study of brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma. Ann Oncol. 2022;33:288–98.CrossRefPubMed Horwitz S, O’Connor OA, Pro B, Trümper L, Iyer S, Advani R, et al. The ECHELON-2 Trial: 5-year results of a randomized, phase III study of brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma. Ann Oncol. 2022;33:288–98.CrossRefPubMed
41.
Zurück zum Zitat Advani RH, Ansell SM, Lehowicz MJ, et al. A phase II study of cyclophosphamide, etoposide, vincristine and prednisone (CEOP) Alternating with Pralatrexate (P) as front line therapy for patients with peripheral T-cell lymphoma (PTCL): final results from the T- cell consortium trial. Br J Haematol. 2016;172:535–44. https://doi.org/10.1111/bjh.13855.CrossRefPubMed Advani RH, Ansell SM, Lehowicz MJ, et al. A phase II study of cyclophosphamide, etoposide, vincristine and prednisone (CEOP) Alternating with Pralatrexate (P) as front line therapy for patients with peripheral T-cell lymphoma (PTCL): final results from the T- cell consortium trial. Br J Haematol. 2016;172:535–44. https://​doi.​org/​10.​1111/​bjh.​13855.CrossRefPubMed
43.
Zurück zum Zitat ClinicalTrials.gov. National Library of Medicine (U.S.). (August 22, 2011- November 19, 2021) Study of pralatrexate versus observation following CHOP-based chemotherapy in previously undiagnosed peripheral T-cell lymphoma patients. Identifier NCT01420679. Retrieved December 1 from https://www.clinicaltrials.gov/ct2/show/NCT01420679 ClinicalTrials.gov. National Library of Medicine (U.S.). (August 22, 2011- November 19, 2021) Study of pralatrexate versus observation following CHOP-based chemotherapy in previously undiagnosed peripheral T-cell lymphoma patients. Identifier NCT01420679. Retrieved December 1 from https://​www.​clinicaltrials.​gov/​ct2/​show/​NCT01420679
44.
Zurück zum Zitat Martinez-Høyer S, Karsan A. Mechanisms of lenalidomide sensitivity and resistance. Exp Hematol. 2020;91:22–31.CrossRefPubMed Martinez-Høyer S, Karsan A. Mechanisms of lenalidomide sensitivity and resistance. Exp Hematol. 2020;91:22–31.CrossRefPubMed
49.
Zurück zum Zitat •• Bachy E, Camus V, Thieblemont C, Sibon D, Casasnovas RO, Ysebaert L, et al. Romidepsin plus CHOP versus CHOP in patients with previously untreated peripheral T-Cell lymphoma: results of the Ro-CHOP Phase III Study (Conducted by LYSA). J Clin Oncol. 2022;40:242–51. https://doi.org/10.1200/JCO.21.01815. Despite being negative, this trial established CHOP as the current standard of care in majority of peripheral T-cell NHL.CrossRefPubMed •• Bachy E, Camus V, Thieblemont C, Sibon D, Casasnovas RO, Ysebaert L, et al. Romidepsin plus CHOP versus CHOP in patients with previously untreated peripheral T-Cell lymphoma: results of the Ro-CHOP Phase III Study (Conducted by LYSA). J Clin Oncol. 2022;40:242–51. https://​doi.​org/​10.​1200/​JCO.​21.​01815. Despite being negative, this trial established CHOP as the current standard of care in majority of peripheral T-cell NHL.CrossRefPubMed
53.
Zurück zum Zitat Ganjoo K, Hong F, Horning SJ, Gascoyne RD, Natkunam Y, Swinnen LJ, et al. N Bevacizumab and cyclosphosphamide, doxorubicin, vincristine and prednisone in combination for patients with peripheral T-cell or natural killer cell neoplasms: an Eastern Cooperative Oncology Group study (E2404). Leuk Lymphoma. 2014;55:768–72. https://doi.org/10.3109/10428194.2013.816700.CrossRefPubMed Ganjoo K, Hong F, Horning SJ, Gascoyne RD, Natkunam Y, Swinnen LJ, et al. N Bevacizumab and cyclosphosphamide, doxorubicin, vincristine and prednisone in combination for patients with peripheral T-cell or natural killer cell neoplasms: an Eastern Cooperative Oncology Group study (E2404). Leuk Lymphoma. 2014;55:768–72. https://​doi.​org/​10.​3109/​10428194.​2013.​816700.CrossRefPubMed
Metadaten
Titel
First-Line Therapy for Nodal T-cell Non-Hodgkin Lymphomas: an Unmet Need in Hematology
verfasst von
Vibor Milunović
Inga Mandac Smoljanović
Martina Bogeljić Patekar
Viktor Zatezalo
Marin Kursar
Delfa Radić-Krišto
Slobodanka Ostojić Kolonić
Slavko Gašparov
Publikationsdatum
12.04.2023
Verlag
Springer US
Erschienen in
Current Oncology Reports / Ausgabe 7/2023
Print ISSN: 1523-3790
Elektronische ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-023-01400-w

Weitere Artikel der Ausgabe 7/2023

Current Oncology Reports 7/2023 Zur Ausgabe

Labor, CT-Anthropometrie zeigen Risiko für Pankreaskrebs

13.05.2024 Pankreaskarzinom Nachrichten

Gerade bei aggressiven Malignomen wie dem duktalen Adenokarzinom des Pankreas könnte Früherkennung die Therapiechancen verbessern. Noch jedoch klafft hier eine Lücke. Ein Studienteam hat einen Weg gesucht, sie zu schließen.

Viel pflanzliche Nahrung, seltener Prostata-Ca.-Progression

12.05.2024 Prostatakarzinom Nachrichten

Ein hoher Anteil pflanzlicher Nahrung trägt möglicherweise dazu bei, das Progressionsrisiko von Männern mit Prostatakarzinomen zu senken. In einer US-Studie war das Risiko bei ausgeprägter pflanzlicher Ernährung in etwa halbiert.

Alter verschlechtert Prognose bei Endometriumkarzinom

11.05.2024 Endometriumkarzinom Nachrichten

Ein höheres Alter bei der Diagnose eines Endometriumkarzinoms ist mit aggressiveren Tumorcharakteristika assoziiert, scheint aber auch unabhängig von bekannten Risikofaktoren die Prognose der Erkrankung zu verschlimmern.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.