Sequencing and Real-World Use of Duvelisib Today

Brammer and Zinzani discuss how duvelisib is being used in practice and where it belongs in the treatment sequence for peripheral T-cell lymphoma. Brammer describes turning to the agent when insurance access allows, noting that since the PRIMO data emerged he has incorporated it frequently, including in earlier relapse and occasionally frontline settings, with good results particularly in the T-follicular helper group and in bridging patients toward transplant. The experts agree that the agent is well suited to the first-relapse setting, especially for T-follicular helper disease, where it has been reflected in treatment guidelines for some time. Zinzani notes a separate ongoing US frontline effort evaluating chemotherapy backbones in combination with duvelisib and other agents, and both reflect on the long history of attempts to improve standard induction. They anticipate that maturing trial data over the next one to two years will help clarify duvelisib's optimal position