Optimizing Treatment of Peripheral T-cell Lymphoma

Kenneth R. Carson, MD, PhD, of the St. Louis VAMC and Washington University was the lead author of the study.

St. LOUIS—Long-term survival in patients with aggressive peripheral T-cell lymphoma (PTCL) is generally poor, no clear consensus exists on optimal initial therapy, according to a new study.

The report in the journal Cancer was on the results of an analysis of treatment patterns and outcomes in a prospectively collected cohort of patients with a new diagnosis of nodal PTCL in the United States.1

St. Louis VAMC-led researchers conducted the Comprehensive Oncology Measures for Peripheral T-cell Lymphoma Treatment (COMPLETE) trial, a prospective multicenter cohort study designed to identify the most common prevailing treatment patterns used for patients newly diagnosed with PTCL in the United States. Included in the analysis were patients with nodal PTCL and completed records regarding baseline characteristics and initial therapy.

Of the 499 patients, 51.3% had nodal PTCL and completed treatment records. As initial therapy, patients received doxorubicin-containing regimens (41.8%), regimens containing doxorubicin plus etoposide (20.9%), other etoposide regimens (15.8%), other single-agent or combination regimens (19.2%) and gemcitabine-containing regimens (2.1%).

Results indicated that survival was statistically significantly longer for patients who received doxorubicin (log-rank P =0.03). After controlling for disease histology and International Prognostic Index, results demonstrated a trend toward significance in mortality reduction in patients who received doxorubicin compared with those who did not, for a hazard ratio of 0.71.

“To the authors’ knowledge, there is no clear standard of care in the treatment of patients with PTCL in the United States,” the researchers pointed out. “Although efforts to improve front-line treatments are necessary, anthracyclines remain an important component of initial therapy for curative intent.”  

Carson KR, Horwitz SM, Pinter-Brown LC, Rosen ST, et. al. A prospective cohort study of patients with peripheral T-cell lymphoma in the United States. Cancer. 2017 Apr 1;123(7):1174-1183. doi: 10.1002/cncr.30416. Epub 2016 Dec 2. PubMed PMID: 27911989; PubMed Central PMCID: PMC5650190.

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