Changing the Paradigms of Treatment in Peripheral T-cell Lymphoma: From Biology to Clinical Practice
Changing the Paradigms of Treatment in Peripheral T-cell Lymphoma: From Biology to Clinical Practice
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DOI：
10.1158/1078-0432.ccr-14-2020
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发表时间：
2014-10-15
影响因子：
11.5
通讯作者：
Bates, Susan E.
中科院分区：
文献类型：
--
作者：
O'Connor, Owen A.;Bhagat, Govind;Bates, Susan E.
尽管我们对侵袭性淋巴瘤的理解取得了巨大的进步，但很明显，外周t细胞淋巴瘤（PTCL）的进展远远落后于其他b细胞恶性肿瘤。虽然这有很多原因，但一项被普遍引用的研究指出，弥漫性大b细胞淋巴瘤（DLBCL）的范式仅适用于所有PTCL患者，这是经典的“一刀切”方法。尽管存在这些挑战，但仍在取得进展。最近，FDA在过去5年中批准了4种用于复发/难治性PTCL患者的药物，如果将日本最近批准的用于成人t细胞白血病/淋巴瘤患者的抗ccr4单克隆抗体计算在内，全球已经批准了5种药物。这些努力导致了至少四项随机临床研究的启动，探索将这些新药整合到新诊断PTCL患者的标准CHOP（环磷酰胺-阿霉素-长春新碱-强的松）化疗方案中。此外，一波新的研究正在探索新的药物组合治疗疾病的优点，这是在单药成功的基础上的努力。最近出现的是认识到PTCL可能是一种以表观遗传失调为特征的疾病，这可能有助于解释其对组蛋白去乙酰化酶（HDAC）抑制剂的敏感性，并为更有创造性的组合方法打开大门。尽管如此，在相对较短的时间内取得的进展正在改变我们现在对这些疾病的看法，并有望使我们最终改善其预后。AACR (C) 2014。
Despite enormous advances in our understanding of aggressive lymphomas, it is clear that progress in the peripheral T-cell lymphomas (PTCL) has lagged well behind other B-cell malignancies. Although there are many reasons for this, the one commonly cited notes that the paradigms for diffuse large B-cell lymphoma (DLBCL) were merely applied to all patients with PTCL, the classic "one-size-fits-all" approach. Despite these challenges, progress is being made. Recently, the FDA has approved four drugs for patients with relapsed/refractory PTCL over the past 5 years, and if one counts the recent Japanese approval of the anti-CCR4 monoclonal antibody for patients with adult T-cell leukemia/lymphoma, five drugs have been approved worldwide. These efforts have led to the initiation of no fewer than four randomized clinical studies exploring the integration of these new agents into standard CHOP (cyclophosphamide-Adriamycin-vincristine-prednisone)-based chemotherapy regimens for patients with newly diagnosed PTCL. In addition, a new wave of studies are exploring the merits of novel drug combinations in the disease, an effort to build on the obvious single-agent successes. What has emerged most recently is the recognition that the PTCL may be a disease-characterized by epigenetic dysregulation, which may help explain its sensitivity to histone deacetylase (HDAC) inhibitors, and open the door for even more creative combination approaches. Nonetheless, advances made over a relatively short period of time are changing how we now view these diseases and, hopefully, have poised us to finally improve its prognosis. (C)2014 AACR.