Single agents vs combination chemotherapy in relapsed and refractory peripheral T-cell lymphoma

Results from the comprehensive oncology measures for peripheral T-cell lymphoma treatment (COMPLETE) registry

Robert N. Stuver, Niloufer Khan, Marc Schwartz, Mark Acosta, Massimo Federico, Christian Gisselbrecht, Steven M. Horwitz, Frederik Lansigan, Lauren C. Pinter-Brown, Barbara Pro, Andrei R. Shustov, Francine M. Foss, Salvia Jain*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Single agents have demonstrated activity in relapsed and refractory (R/R) peripheral T-cell lymphoma (PTCL). Their benefit relative to combination chemotherapy remains undefined. Patients with histologically confirmed PTCL were enrolled in the Comprehensive Oncology Measures for Peripheral T-cell Lymphoma Treatment (COMPLETE) registry. Eligibility criteria included those with R/R disease who had received one prior systemic therapy and were given either a single agent or combination chemotherapy as first retreatment. Treatment results for those with R/R disease who received single agents were compared to those who received combination chemotherapy. The primary endpoint was best response to retreatment. Fifty-seven patients met eligibility criteria. At first retreatment, 46% (26/57) received combination therapy and 54.5% (31/57) received single agents. At median follow up of 2 years, a trend was seen towards increased complete response rate for single agents versus combination therapy (41% vs 19%; P =.02). There was also increased median overall survival (38.9 vs 17.1 months; P =.02) and progression-free survival (11.2 vs 6.7 months; P =.02). More patients receiving single agents received hematopoietic stem-cell transplantation (25.8% vs 7.7%, P =.07). Adverse events of grade 3 or 4 occurred more frequently in those receiving combination therapy, although this was not statistically significant. The data confirm the unmet need for better treatment in R/R PTCL. Despite a small sample, the analysis shows greater response and survival in those treated with single agents as first retreatment in R/R setting, while maintaining the ability to achieve transplantation. Large, randomized trials are needed to identify the best strategy.

Original languageEnglish (US)
Pages (from-to)641-649
Number of pages9
JournalAmerican Journal of Hematology
Volume94
Issue number6
DOIs
StatePublished - Jun 1 2019

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Peripheral T-Cell Lymphoma
Combination Drug Therapy
Registries
Retreatment
Therapeutics
Survival
Hematopoietic Stem Cell Transplantation
Disease-Free Survival
Transplantation

ASJC Scopus subject areas

  • Hematology

Cite this

Stuver, Robert N. ; Khan, Niloufer ; Schwartz, Marc ; Acosta, Mark ; Federico, Massimo ; Gisselbrecht, Christian ; Horwitz, Steven M. ; Lansigan, Frederik ; Pinter-Brown, Lauren C. ; Pro, Barbara ; Shustov, Andrei R. ; Foss, Francine M. ; Jain, Salvia. / Single agents vs combination chemotherapy in relapsed and refractory peripheral T-cell lymphoma : Results from the comprehensive oncology measures for peripheral T-cell lymphoma treatment (COMPLETE) registry. In: American Journal of Hematology. 2019 ; Vol. 94, No. 6. pp. 641-649.
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title = "Single agents vs combination chemotherapy in relapsed and refractory peripheral T-cell lymphoma: Results from the comprehensive oncology measures for peripheral T-cell lymphoma treatment (COMPLETE) registry",
abstract = "Single agents have demonstrated activity in relapsed and refractory (R/R) peripheral T-cell lymphoma (PTCL). Their benefit relative to combination chemotherapy remains undefined. Patients with histologically confirmed PTCL were enrolled in the Comprehensive Oncology Measures for Peripheral T-cell Lymphoma Treatment (COMPLETE) registry. Eligibility criteria included those with R/R disease who had received one prior systemic therapy and were given either a single agent or combination chemotherapy as first retreatment. Treatment results for those with R/R disease who received single agents were compared to those who received combination chemotherapy. The primary endpoint was best response to retreatment. Fifty-seven patients met eligibility criteria. At first retreatment, 46{\%} (26/57) received combination therapy and 54.5{\%} (31/57) received single agents. At median follow up of 2 years, a trend was seen towards increased complete response rate for single agents versus combination therapy (41{\%} vs 19{\%}; P =.02). There was also increased median overall survival (38.9 vs 17.1 months; P =.02) and progression-free survival (11.2 vs 6.7 months; P =.02). More patients receiving single agents received hematopoietic stem-cell transplantation (25.8{\%} vs 7.7{\%}, P =.07). Adverse events of grade 3 or 4 occurred more frequently in those receiving combination therapy, although this was not statistically significant. The data confirm the unmet need for better treatment in R/R PTCL. Despite a small sample, the analysis shows greater response and survival in those treated with single agents as first retreatment in R/R setting, while maintaining the ability to achieve transplantation. Large, randomized trials are needed to identify the best strategy.",
author = "Stuver, {Robert N.} and Niloufer Khan and Marc Schwartz and Mark Acosta and Massimo Federico and Christian Gisselbrecht and Horwitz, {Steven M.} and Frederik Lansigan and Pinter-Brown, {Lauren C.} and Barbara Pro and Shustov, {Andrei R.} and Foss, {Francine M.} and Salvia Jain",
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Stuver, RN, Khan, N, Schwartz, M, Acosta, M, Federico, M, Gisselbrecht, C, Horwitz, SM, Lansigan, F, Pinter-Brown, LC, Pro, B, Shustov, AR, Foss, FM & Jain, S 2019, 'Single agents vs combination chemotherapy in relapsed and refractory peripheral T-cell lymphoma: Results from the comprehensive oncology measures for peripheral T-cell lymphoma treatment (COMPLETE) registry', American Journal of Hematology, vol. 94, no. 6, pp. 641-649. https://doi.org/10.1002/ajh.25463

Single agents vs combination chemotherapy in relapsed and refractory peripheral T-cell lymphoma : Results from the comprehensive oncology measures for peripheral T-cell lymphoma treatment (COMPLETE) registry. / Stuver, Robert N.; Khan, Niloufer; Schwartz, Marc; Acosta, Mark; Federico, Massimo; Gisselbrecht, Christian; Horwitz, Steven M.; Lansigan, Frederik; Pinter-Brown, Lauren C.; Pro, Barbara; Shustov, Andrei R.; Foss, Francine M.; Jain, Salvia.

In: American Journal of Hematology, Vol. 94, No. 6, 01.06.2019, p. 641-649.

Research output: Contribution to journalArticle

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T1 - Single agents vs combination chemotherapy in relapsed and refractory peripheral T-cell lymphoma

T2 - Results from the comprehensive oncology measures for peripheral T-cell lymphoma treatment (COMPLETE) registry

AU - Stuver, Robert N.

AU - Khan, Niloufer

AU - Schwartz, Marc

AU - Acosta, Mark

AU - Federico, Massimo

AU - Gisselbrecht, Christian

AU - Horwitz, Steven M.

AU - Lansigan, Frederik

AU - Pinter-Brown, Lauren C.

AU - Pro, Barbara

AU - Shustov, Andrei R.

AU - Foss, Francine M.

AU - Jain, Salvia

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Single agents have demonstrated activity in relapsed and refractory (R/R) peripheral T-cell lymphoma (PTCL). Their benefit relative to combination chemotherapy remains undefined. Patients with histologically confirmed PTCL were enrolled in the Comprehensive Oncology Measures for Peripheral T-cell Lymphoma Treatment (COMPLETE) registry. Eligibility criteria included those with R/R disease who had received one prior systemic therapy and were given either a single agent or combination chemotherapy as first retreatment. Treatment results for those with R/R disease who received single agents were compared to those who received combination chemotherapy. The primary endpoint was best response to retreatment. Fifty-seven patients met eligibility criteria. At first retreatment, 46% (26/57) received combination therapy and 54.5% (31/57) received single agents. At median follow up of 2 years, a trend was seen towards increased complete response rate for single agents versus combination therapy (41% vs 19%; P =.02). There was also increased median overall survival (38.9 vs 17.1 months; P =.02) and progression-free survival (11.2 vs 6.7 months; P =.02). More patients receiving single agents received hematopoietic stem-cell transplantation (25.8% vs 7.7%, P =.07). Adverse events of grade 3 or 4 occurred more frequently in those receiving combination therapy, although this was not statistically significant. The data confirm the unmet need for better treatment in R/R PTCL. Despite a small sample, the analysis shows greater response and survival in those treated with single agents as first retreatment in R/R setting, while maintaining the ability to achieve transplantation. Large, randomized trials are needed to identify the best strategy.

AB - Single agents have demonstrated activity in relapsed and refractory (R/R) peripheral T-cell lymphoma (PTCL). Their benefit relative to combination chemotherapy remains undefined. Patients with histologically confirmed PTCL were enrolled in the Comprehensive Oncology Measures for Peripheral T-cell Lymphoma Treatment (COMPLETE) registry. Eligibility criteria included those with R/R disease who had received one prior systemic therapy and were given either a single agent or combination chemotherapy as first retreatment. Treatment results for those with R/R disease who received single agents were compared to those who received combination chemotherapy. The primary endpoint was best response to retreatment. Fifty-seven patients met eligibility criteria. At first retreatment, 46% (26/57) received combination therapy and 54.5% (31/57) received single agents. At median follow up of 2 years, a trend was seen towards increased complete response rate for single agents versus combination therapy (41% vs 19%; P =.02). There was also increased median overall survival (38.9 vs 17.1 months; P =.02) and progression-free survival (11.2 vs 6.7 months; P =.02). More patients receiving single agents received hematopoietic stem-cell transplantation (25.8% vs 7.7%, P =.07). Adverse events of grade 3 or 4 occurred more frequently in those receiving combination therapy, although this was not statistically significant. The data confirm the unmet need for better treatment in R/R PTCL. Despite a small sample, the analysis shows greater response and survival in those treated with single agents as first retreatment in R/R setting, while maintaining the ability to achieve transplantation. Large, randomized trials are needed to identify the best strategy.

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