Biomarker-driven management strategies for peripheral T cell lymphoma

J Hematol Oncol. 2020 May 24;13(1):59. doi: 10.1186/s13045-020-00889-z.

Abstract

Peripheral T cell lymphomas are heterogeneous diseases which remain treatment challenges. Recent advances in molecular and genomic profiling have provided unprecedented insight into disease pathogenesis driven by distinct cells of origins and molecular pathways. The discovery and clinical application of molecular biomarkers in PTCL subtypes has the potential to transform personalized care for patients with PTCL in diagnosis, prognosis, and therapy. Targeting CD30+ PTCL with the antibody-drug conjugate brentuximab vedotin in the relapsed setting and in combination with chemotherapy in the frontline setting has improved patient survivals. Epigenetic modifying agents, including HDAC inhibitors and hypomethylating agents, have demonstrated broad clinical efficacy and durability and are in clinical development for combination strategies for both relapsed and frontline settings. Wide-ranging novel agents targeting critical intracellular pathways and tumor microenvironment are in active exploration to define clinical activities. This review summarizes PTCL-specific biomarkers which are increasingly incorporated in clinical practice to guide precision diagnosis and personalized treatment.

Keywords: CD30-positive peripheral T cell lymphoma (PTCL); Epigenetic targeting; HDAC inhibitors; Hypomethylating agents; Nodal PTCL with T follicular helper (TFH) phenotype; Tumor microenvironment.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Agents, Immunological / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / antagonists & inhibitors*
  • Consolidation Chemotherapy
  • Disease Management
  • Enzyme Inhibitors / therapeutic use
  • Epigenesis, Genetic / drug effects
  • Forecasting
  • Humans
  • Immunoconjugates / pharmacology
  • Immunoconjugates / therapeutic use*
  • Leukemia-Lymphoma, Adult T-Cell / drug therapy
  • Lymphoma, Extranodal NK-T-Cell / drug therapy
  • Lymphoma, Large-Cell, Anaplastic / drug therapy
  • Lymphoma, T-Cell, Peripheral / drug therapy*
  • Maintenance Chemotherapy
  • Molecular Targeted Therapy / methods*
  • Neoplasm Proteins / antagonists & inhibitors*
  • Precision Medicine / methods*
  • Precision Medicine / trends
  • Signal Transduction / drug effects
  • Therapies, Investigational / methods*
  • Tumor Microenvironment / drug effects

Substances

  • Antineoplastic Agents
  • Antineoplastic Agents, Immunological
  • Biomarkers, Tumor
  • Enzyme Inhibitors
  • Immunoconjugates
  • Neoplasm Proteins