Final PRIMO Trial Results and the Phase 3 TERZO Trial of Duvelisib in Relapsed/Refractory Peripheral T-Cell Lymphoma

Jonathan Brammer, MD, of The Ohio State University, and Pier Luigi Zinzani, MD, of the University of Bologna, open a discussion devoted to duvelisib in peripheral T-cell lymphoma. Brammer introduces himself as a researcher focused on T-cell malignancies, and Zinzani notes his work as a hematologist with broad experience across lymphoma subtypes and a particular interest in peripheral T-cell lymphoma. Together they frame the conversation around a disease setting that has seen little meaningful progress in recent decades, positioning duvelisib as a development of genuine interest for patients with limited options. Brammer establishes that the discussion will center on the agent's activity in T-cell lymphomas and, in particular, on the recently reported results from the PRIMO study. The introduction sets expectations for a wide-ranging exchange that will move from the current treatment landscape through trial data, mechanism, sequencing, and future directions in this rare and challenging group of diseases.

Zinzani outlines the limited options available to European patients with relapsed or refractory peripheral T-cell lymphoma, emphasizing how few effective therapies exist once frontline treatment fails. He describes a reliance on single-agent chemotherapies such as bendamustine and gemcitabine, sometimes combined as part of regimens used more broadly in lymphoma management. Zinzani stresses that the outcomes with these approaches remain consistently poor regardless of histologic subtype, with overall response rates that rarely exceed roughly 30%, complete metabolic responses in only a small minority of patients, and progression-free survival measured in just a few months. He frames this as a genuinely difficult and longstanding clinical situation, one that leaves clinicians with little to offer patients whose disease has returned. The segment establishes the European baseline against which newer agents such as duvelisib must be judged, underscoring the substantial unmet need that motivates ongoing trial efforts across the continent.