Abstract
BACKGROUND: Long-term survival in patients with aggressive peripheral T-cell lymphoma (PTCL) is generally poor, and there currently is no clear consensus regarding the initial therapy used for these diseases. Herein, the authors analyzed treatment patterns and outcomes in a prospectively collected cohort of patients with a new diagnosis of nodal PTCL in the United States. METHODS: Comprehensive Oncology Measures for Peripheral T-cell Lymphoma Treatment (COMPLETE) is 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. Patients with nodal PTCL and completed records regarding baseline characteristics and initial therapy were included in this analysis. All statistical tests were 2-sided. RESULTS: Of a total of 499 patients enrolled, 256 (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%). Survival was found to be statistically significantly longer for patients who received doxorubicin (log-rank P =.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 (hazard ratio, 0.71; 95% confidence interval, 0.48-1.05 [P =.09]). CONCLUSIONS: To the authors' knowledge, there is no clear standard of care in the treatment of patients with PTCL in the United States. Although efforts to improve frontline treatments are necessary, anthracyclines remain an important component of initial therapy for curative intent. Cancer 2017;123:1174–1183.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1174-1183 |
| Number of pages | 10 |
| Journal | cancer |
| Volume | 123 |
| Issue number | 7 |
| DOIs | |
| State | Published - Apr 1 2017 |
Funding
Kenneth R. Carson has acted as a paid consultant for Celgene, Millennium, and Genentech; received personal fees and research funding from Millennium; received research funding from Kyowa Hakko Kirin; and provided expert testimony for AbbVie Inc for work performed outside of the current study. Steven M. Horwitz has acted as a paid consultant for and received research funding from Celgene, Millennium, Seattle Genetics, and Spectrum Pharmaceuticals Inc; has acted as a paid consultant for Bristol-Myers Squibb and Amgen; received research funding from Kyowa Hakko Kirin and Infinity Pharmaceuticals; and received travel expenses from ADC Therapeutics, Janssen, and RAND Corporation for work performed outside of the current study. Lauren C. Pinter-Brown has acted as a paid consultant for Celgene, Spectrum Pharmaceuticals Inc, and Seattle Genetics for work performed outside of the current study. Steven T. Rosen has received personal fees and research funding from Celgene; has acted as a paid consultant for Allos Therapeutics, DAVA Oncology, Defined Health, Elorac Inc, Genentech, IMC Healthcare Communications Premier, Healthcare Resources, ProStrakan Inc, Seattle Genetics, Teva, and TRM Oncology; received research funding from ILEX Pharmaceuticals, Eli Lilly, and Millennium; has provided expert testimony for Fulbrite & Jawarski LLP, Hinshaw & Culbertson LLP, and Hunt Suedhoff & Kalamaros LLP; has stock or other ownership in AuraSense LLC and Nanosphere; and has received honoraria from Celgene, Genentech, Genzyme, Seattle Genetics, Teva, The CM Group, The Medal Group, and Therakos Inc for work performed outside of the current study. Barbara Pro has received research funding from and acted as a consultant for Celgene, research funding and travel expenses from Seattle Genetics, and travel expenses from Takeda for work performed outside of the current study. Eric D. Hsi has received research funding from AbbVie Inc, Cellerant Therapeutics, and Eli Lilly and personal fees from Onyx and Seattle Genetics for work performed outside of the current study. Massimo Federico has acted as a paid consultant for MedNet Solutions for work performed as part of the current study. Christian Gisselbrecht has received research funding from and acted as a member of the Speakers' Bureau for Roche/Genentech for work performed outside of the current study. Marc Schwartz is employed by MedNet Solutions. Lisa A. Bellm has received personal fees from MedNet Solutions for work performed as part of the current study and has stock ownership in Bristol-Myers Squibb, Johnson & Johnson, and Merck. Mark Acosta is an employee of and owns stock in Spectrum Pharmaceuticals Inc. Ranjana H. Advani has received personal fees and research funding from Genentech/Roche; acted as a paid consultant for Forty Seven Inc; acted as a paid consultant and received travel expenses from Kyowa Hakko Kirin; and received research funding from Millennium, Seattle Genetics, Allos Therapeutics, Pharmacyclics, Janssen, Celgene, Idera, Agensys, Merck, Kura Oncology, Regeneron, and Infinity Pharmaceuticals for work performed outside of the current study. Tatyana A. Feldman has acted as a consultant for Celgene, Novartis, and Seattle Genetics; received honoraria from Celgene, Pharmacyclics, and Seattle Genetics; and acted as a member of the Speakers' Bureau for Celgene, Seattle Genetics, and Pharmacyclics for work performed outside of the current study. Mary Jo Lechowicz has acted as a paid consultant for Seattle Genetics, Spectrum Pharmaceuticals Inc, and Soligenix Inc for work performed outside of the current study. Sonali M. Smith has acted as a paid consultant for Genentech, Onyx, Seattle Genetics, TG Therapeutics, Gilead, Immunogenix, and Pharmacyclics and received honoraria from Celgene and Janssen for work performed outside of the current study. Frederick Lansigan has acted as a paid consultant for Celgene and received research funding from Spectrum Pharmaceuticals Inc and Teva for work performed outside of the current study. Brad S. Kahl has acted as a paid consultant for Seattle Genetics and Celgene for work performed outside of the current study. Joseph W. Leach has received research funding from Bristol-Myers Squibb, AstraZeneca, Merck, and Halozyme Therapeutics. Steven I. Park has received research funding from Teva and Seattle Genetics and travel expenses from Janssen for work performed outside of the current study. Francine M. Foss has acted as a paid consultant for Celgene, Seattle Genetics, Spectrum Pharmaceuticals Inc, and Eisai; received research funding from Celgene; and acted as a member of the Speakers' Bureau for Celgene and Seattle Genetics for work performed outside of the current study. Funding received from Spectrum Pharmaceuticals Inc.
Keywords
- T cell
- anthracyclines
- cohort studies
- drug therapy
- lymphoma
- peripheral
- prospective studies
- treatment outcome
ASJC Scopus subject areas
- Oncology
- Cancer Research
