Future Directions in Frontline and Combination Therapy for PTCL

Looking ahead, Zinzani and Brammer consider how peripheral T-cell lymphoma treatment may evolve toward frontline and combination strategies. Zinzani anticipates that PI3K inhibition, and duvelisib specifically, will increasingly move from the relapsed setting toward earlier lines, while pointing to other pathways of interest, including JAK inhibition, as additional avenues under investigation. Both emphasize the value of selecting therapy by histologic subtype given the considerable biologic heterogeneity within the peripheral T-cell lymphoma umbrella. Brammer frames duvelisib as a likely treatment of choice for T-follicular helper and angioimmunoblastic disease and explores the potential of combinations, while cautioning that combination data remain early and that meaningful study often awaits broader drug availability. The experts agree that advancing into the frontline will ultimately require chemotherapy-free regimens capable of improving on standard induction, and they stress that rare, single-subtype disease demands coordinated, multicenter international collaboration to generate definitive evidence.