A specific sequence of therapies can improve outcomes for patients with some aggressive forms of lymphoma, according to a new study.
Reporting in the British Journal of Haematology, researchers report using a range of techniques to identify an alternative to chemotherapy for relapsed/refractory mature T and natural killer cell lymphomas (TNKL).
The study, led by a team from Massachusetts, USA, suggests using small molecule inhibitors as second-line treatment and epigenetic modifiers as third-line therapy.
The conclusions come from a retrospective analysis of the peripheral T cell lymphoma (PETAL) consortium.
The researchers used machine learning to compare 12 possible treatment paths for second- and third-line therapies. There were 540 patients receiving second line treatment and 290 receiving third-line treatment.
Researcher Dr Mark Sorial, of the Massachusetts General Cancer Center, said: “Our robust study design, multiple stability analyses and independent machine learning models using the PETAL global dataset all pointed to the same conclusion: targeted therapies and epigenetic modifiers consistently showed benefit over chemotherapy for patients with relapsed/refractory T-cell/NK-cell lymphomas.
“These results support the earlier use of these novel therapies, prioritise further research of these drug classes - and provide a framework for examining survival effects with sequential treatments in other cancers. They also highlight that targeted signalling inhibitors, like duvelisib, warrant ongoing clinical investigation in this patient population with limited treatment options.”
Source:
Sorial MN, Han JX, Koh MJ, Boussi L, Li S, Duan R, Lu J, Lei MM, MacVicar CT, Freydman J, Malespini J, Aniagboso KN, McCabe SM, Peng L, Singh S, Iwasaki M, Eche-Ugwu IJ, Gabler J, Fernandez Turizo MJ, Garg A, Disciullo A, Chopra K, Ford J, Lenart A, Nwodo E, Barnes J, Koh MJ, Miranda E, Chiattone C, Stuver R, Merrill M, Jacobsen E, Manni M, Civallero M, Skrypets T, Lymboussaki A, Federico M, Kim Y, Kim JS, Cho JY, Eipe T, Shet T, Epari S, Shetty A, Saha S, Jain H, Sengar M, Van Der Weyden C, Prince HM, Hamouche R, Murdashvili T, Foss F, Gentilini M, Casadei B, Zinzani PL, Okatani T, Yoshida N, Yoon SE, Kim WS, Panchoo G, Mohamed Z, Verburgh E, Alturas JC, Al-Mansour M, Cabrera ME, Ku A, Bhagat G, Ma H, Sawas A, Kariya KM, Bhanushali F, Meharwal A, Mistry D, Kosovsky M, Yeterian M, O'Connor OA, Marchi E, Shen C, Shah D, Jain S. (2025) “Forecasting optimal treatments in relapsed/refractory mature T- and NK-cell lymphomas: A global PETAL Consortium study.” British Journal of Haematology, 1 May 2025, doi: 10.1111/bjh.20063.
Link: https://onlinelibrary.wiley.com/doi/10.1111/bjh.20063
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