NK/T cell lymphoma

At the 18th ICML held in Lugano, Dr Alice Wolfromm (Institut Jules Bordet, HUBruxelles) highlighted some interesting presentations regarding the management of NK/T-cell lymphoma. 

A phase 2 trial investigated a treatment for newly diagnosed, localised NK/T-cell lymphoma in frail patients who are ineligible for chemotherapy. The trial included 30 patients treated with six cycles of pembrolizumab combined with 50 Gy concurrent radiotherapy, followed by two years of maintenance pembrolizumab. The treatment yielded excellent results, with an overall response rate exceeding 90% and a CR rate of more than 60%. The treatment combination also demonstrated a favourable safety profile, making it a viable alternative for both frail and fit patients, with results comparable to those seen with MOGAT and P-GemOx treatments.

A Japanese team conducted a retrospective analysis of over 600 patients with NK/T-cell lymphoma, comparing autologous and allogeneic stem cell transplantation. They found that the 5-year OS was higher in the autologous stem cell group (over 60%) compared to the allogenic group (around 40%). However, for partial responders, allogenic stem cell transplantation showed better outcomes. The study concluded that autologous stem cell transplantation is preferable for complete responders, while allogenic stem cell transplantation is more effective for partial responders in NK/T-cell lymphoma patients.

The European NIVEAU trial compared nivolumab combined with GemOx versus GemOx alone in the second-line treatment of transplant-ineligible patients with peripheral T-cell lymphoma (PTCL). The study included approximately 80 patients who were randomised between 8 cycles of GemOx and eight cycles of nivolumab-GemOx, followed by a consolidation treatment of nivolumab for a total treatment duration of one year. The results were disappointing, with an overall response rate of 34% for the GemOx-nivolumab group and 14% for the GemOx group. The 1-year PFS rates were 17% for the GemOx-nivolumab group and 9% for the GemOx group, indicating limited benefit in this relapsed-refractory setting.

The last abstract discussed is from China, evaluating an oral EZH2 inhibitor in patients with relapsed or refractory PTCL. The study reported an overall response rate of over 60%, with more than 30% achieving a CR. The median treatment duration exceeded 18 months, with a median PFS of 10 months, and the median OS had not been reached. These findings suggest the potential of the EZH2 inhibitor as a treatment option for relapsed/refractory PTCL patients.