Novel Treatment Strategies for PTCL

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Multiple clinical trials are exploring romidepsin as a treatment for patients with peripheral T-cell lymphomas (PTCL), explains Myron Czuczman, MD. A phase III study will look at romidepsin plus CHOP versus CHOP alone and a phase II is exploring gemcitabine plus romidepsin in relapsed/refractory PTCL. Additionally, a phase I study is exploring the novel Aurora A kinase inhibitor alisertib in combination with romidepsin for patients with relapsed/refractory T-cell or B-cell lymphomas, Czuczman notes.

In a phase I study, approximately half of patients with T-cell lymphoma responded to treatment with oral alisertib, notes Steven M. Horowitz, MD. However, this response data was from only a few patients, with randomized studies underway. In terms of side effects, alisertib was associated with some neutropenia and stomatitis, Horowitz adds.

In some patients with T-cell lymphoma, consolidation treatment with autologous stem cell transplantation (ASCT) can be useful following relapse on chemotherapy, suggests Lauren C. Pinter-Brown, MD. This approach can be offered to some patients, but not all, Anas Younes, MD, cautions.

At this point, randomized data on the efficacy of ASCT in T cell lymphomas is unavailable. Methods for determining who should receive ASCT need to be developed, to ensure patients are receiving the best treatment option available, notes Horowitz. Interim PET-negativity seems to provide an indication of long-term response; however, long-term data from large trials has not yet confirmed this in T-cell lymphomas, notes Horowitz.