Современная онкология (May 2021)

Modern approaches in the first line treatment of CD30-positive peripheral T-cell lymphomas

  • Irina V. Poddubnaya,
  • Elena A. Bariakh,
  • Sergei V. Voloshin,
  • Liliia G. Gorenkova,
  • Kamil D. Kaplanov,
  • Alla M. Kovrigina,
  • Nataliia B. Mikhailova,
  • Tatiana I. Pospelova,
  • Vadim V. Ptushkin,
  • Gaiane S. Tumian,
  • Natalia A. Falaleeva,
  • Gulnara N. Khusainova

DOI
https://doi.org/10.26442/18151434.2021.1.200698
Journal volume & issue
Vol. 23, no. 1
pp. 167 – 171

Abstract

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Relevance. Peripheral T-cell lymphomas (PTCL) comprise a heterogeneous group of aggressive lymphoproliferative malignancies that account for approximately 10% of adult non-Hodgkins 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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