Treatment Landscape for Nodal Peripheral T-Cell Lymphomas Moving Toward Biomarker-Driven Subtype-Specific Therapy
This Blood review examines the evolving treatment approach for common nodal peripheral T-cell lymphomas including PTCL-NOS, anaplastic large-cell lymphoma, and T-follicular helper lymphomas. The authors highlight how molecular profiling, predictive biomarkers such as CD30 expression, and targeted agents including EZH1/2 and JAK/STAT inhibitors are enabling subtype-specific strategies. For laboratory professionals, the review underscores the growing importance of flow cytometry, molecular testing, and companion diagnostics in guiding PTCL treatment decisions.
The original study
Current and upcoming treatment approaches to common subtypes of PTCL (PTCL, NOS; ALCL; and TFHs).
- Authors
- Moskowitz AJ, Stuver RN, Horwitz SM
- Journal
- Blood
- Type
- Journal Article, Review, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural
- PMID
- 38306597
Original abstract
The treatment of common nodal peripheral T-cell lymphomas (PTCLs), including PTCL, not otherwise specified (PTCL, NOS), anaplastic large-cell lymphomas, and T-follicular helper lymphomas, is evolving. These entities are currently treated similarly with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone (CHOEP) for CD30-negative diseases, or brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone (CHP) for CD30-positive diseases, followed by consolidation with autologous stem cell transplantation in the first remission. Ongoing improvements in PTCL classification, identification of predictive biomarkers, and development of new targeted agents will lead to more specific therapies that address the unique biologic and clinical properties of each entity. For example, widespread efforts focused on molecular profiling of PTCL, NOS is likely to identify distinct subtypes that warrant different treatment approaches. New agents, such as EZH1/2 and JAK/STAT pathway inhibitors, have broadened treatment options for relapsed or refractory diseases. Furthermore, promising strategies for optimizing immune therapy for PTCL are currently under investigation and have the potential to significantly alter the therapeutic landscape. Ongoing frontline study designs incorporate an understanding of disease biology and drug sensitivities and are poised to evaluate whether newer-targeted agents should be incorporated into frontline settings for various disease entities. Although current treatment strategies lump most disease entities together, future treatments will include distinct strategies for each disease subtype that optimize therapy for individuals. This movement toward individualized therapy will ultimately lead to dramatic improvements in the prognosis of patients with PTCL.