Email this article Modern approaches in the first line treatment of CD30-positive peripheral T-cell lymphomas
- Authors: Poddubnaya I.V.1, Bariakh E.A.1,2,3, Voloshin S.V.4, Gorenkova L.G.5, Kaplanov K.D.6, Kovrigina A.M.5,7, Mikhailova N.B.8, Pospelova T.I.9, Ptushkin V.V.6, Tumian G.S.1,10, Falaleeva N.A.11, Khusainova G.N.12
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Affiliations:
- Russian Medical Academy of Continuous Professional Education
- City Clinical Hospital №52
- Pirogov Russian National Research Medical University
- Russian Research Institute of Hematology and Transfusiology,
- National Medical Research Center for Hematology
- Botkin City Clinical Hospital
- Academy of Postgraduate Education of Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies
- Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology and Transplantation of Pavlov First Saint Petersburg State Medical University
- Novosibirsk State Medical University
- Blokhin National Medical Research Center of Oncology
- Tsyb Medical Radiological Research Centre – branch of the NationaL Medical Research Radiological Centre
- Republican Oncological Clinical Dispensary
- Issue: Vol 23, No 1 (2021)
- Pages: 167-171
- Section: CLINICAL ONCOLOGY
- URL: https://bakhtiniada.ru/1815-1434/article/view/70485
- DOI: https://doi.org/10.26442/18151434.2021.1.200698
- ID: 70485
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Abstract
Relevance. Peripheral T-cell lymphomas (PTCL) comprise a heterogeneous group of aggressive lymphoproliferative malignancies that account for approximately 10% of adult non-Hodgkin’s lymphomas. Despite the variety of PTCL subtypes, CHOP-like regimens are the standard first-line therapy in most cases. At the same time, the level of complete remissions at the using these schemes is about 39%, the 2-year event-free survival rate does not exceed 45%. The possibilities of subsequent therapy of patients are very limited: the median overall survival after relapse is only 6.5 months. The most significant results were obtained only in patients with relapses of anaplastic large cell lymphoma after the use of the targeted drug brentuximab vedotin – BV (conjugate of a CD30-directed monoclonal antibody and an antitumor agent). Given the favorable safety profile of this drug, a phase 3, double-blind, randomized study (ECHELON-2) was initiated and conducted comparing the efficacy and safety of the combination of BV with CHP (cyclophosphamide, doxorubicin, prednisolone) (BV+CHP) and standard CHOP regimen in previously untreated patients with CD30-positive PTCL.
Aim. Discuss the entire spectrum of unmet medical needs in the treatment of patients with PTCL and adapt existing approaches taking into account new therapeutic options (results of the protocol ECHELON-2).
Results. The advantages of the BV+CHP regimen in the treatment of previously untreated patients with CD30-positive PTCL were recognized as convincing. Given the lack of real therapeutic options, it is recommended to register in Russia a “broad” indication for BV: “treatment of previously untreated CD30-expressing peripheral T-cell lymphomas (in combination with CHP)”. It was considered expedient to include the BV+CHP regimen in the updated Clinical Guidelines for the Treatment of Lymphoproliferative Diseases.
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##article.viewOnOriginalSite##About the authors
Irina V. Poddubnaya
Russian Medical Academy of Continuous Professional Education
Author for correspondence.
Email: ivprectorat@inbox.ru
ORCID iD: 0000-0002-0995-1801
D. Sci. (Med.), Prof., Acad. RAS, Russian Medical Academy of Continuous Professional Education
Russian Federation, MoscowElena A. Bariakh
Russian Medical Academy of Continuous Professional Education;City Clinical Hospital №52; Pirogov Russian National Research Medical University
Email: ivprectorat@inbox.ru
D. Sci. (Med.), Prof.
Russian Federation, Moscow; Moscow; MoscowSergei V. Voloshin
Russian Research Institute of Hematology and Transfusiology,
Email: ivprectorat@inbox.ru
Cand. Sci. (Med.)
Russian Federation, Saint PetersburgLiliia G. Gorenkova
National Medical Research Center for Hematology
Email: ivprectorat@inbox.ru
Cand. Sci. (Med.)
Russian Federation, MoscowKamil D. Kaplanov
Botkin City Clinical Hospital
Email: ivprectorat@inbox.ru
Cand. Sci. (Med.)
Russian Federation, MoscowAlla M. Kovrigina
National Medical Research Center for Hematology; Academy of Postgraduate Education of Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies
Email: ivprectorat@inbox.ru
D. Sci. (Biol.), Prof.
Russian Federation, Moscow; MoscowNataliia B. Mikhailova
Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology and Transplantation of Pavlov First Saint Petersburg State Medical University
Email: ivprectorat@inbox.ru
Cand. Sci. (Med.)
Russian Federation, Saint PetersburgTatiana I. Pospelova
Novosibirsk State Medical University
Email: ivprectorat@inbox.ru
D. Sci. (Med.), Prof.
Russian Federation, NovosibirskVadim V. Ptushkin
Botkin City Clinical Hospital
Email: ivprectorat@inbox.ru
D. Sci. (Med.), Prof.
Russian Federation, MoscowGaiane S. Tumian
Russian Medical Academy of Continuous Professional Education; Blokhin National Medical Research Center of Oncology
Email: ivprectorat@inbox.ru
D. Sci. (Med.)
Russian Federation, Moscow; MoscowNatalia A. Falaleeva
Tsyb Medical Radiological Research Centre – branch of the NationaL Medical Research Radiological Centre
Email: ivprectorat@inbox.ru
D. Sci. (Med.)
Russian Federation, ObninskGulnara N. Khusainova
Republican Oncological Clinical Dispensary
Email: ivprectorat@inbox.ru
Cand. Sci. (Med.)
Russian Federation, KazanReferences
- Swerdlow S, Harris N, Jaffe E, et al. WHO Classification of Tumours of the Haematopoietic and Lymphoid Tissues. Revised 4th ed. Lyon: IARC, 2017.
- Vose J, Armitage J, Weisenburger D. International peripheral T-cell and natural killer/T-cell lymphoma study: Pathology findings and clinical outcomes. J Clin Oncol 2008; 26: 4124–30.
- Gravanis I. The European Medicines Agency review of Brentuximab Vedotin (Adcetris) for the treatment of adult patients with relapsed or refractory CD30+ Hodgkin lymphoma or systemic anaplastic large cell lymphoma: summary of the scientific assessment of the Committee for Medicinal Products for Human Use. Oncologist 2016; 21 (1): 102–9.
- Simon A, Peoch M, Casassus P, et al. Upfront VIP-reinforced-ABVD (VIP-rABVD) is not superior to CHOP/21 in newly diagnosed peripheral T cell lymphoma: Results of the randomized phase III trial GOELAMS-LTP95. Br J Haematol 2010; 151: 159–66.
- Mak V, Hamm J, Chhanabhai M, et al. Survival of patients with peripheral T-cell lymphoma after first relapse or progression: spectrum of disease and rare long-term survivors. J Clin Oncol 2013; 31 (16): 1970–6.
- Muller P, Martin K, Theurich S, et al. Microtubule-depolymerizing agents used in antibody-drug conjugates induce antitumor immunity by stimulation of dendritic cells. Cancer Immunol Res 2014; 2: 741–55.
- Horwitz S, O’Connor OA, Pro B, et al. Brentuximab Vedotin with Chemotherapy for CD30-Positive Peripheral T-cell Lymphoma (ECHELON-2): a global, double-blind, randomised, phase 3 trial. Lancet 2019; 393 (10168): 229–40.
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