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Peripheral T-cell lymphoma (PTCL) is a group of highly heterogeneous non-Hodgkin's lymphoma (NHL) originating from mature T/NK cells in the thymus.
It is clinically highly aggressive and the disease progresses rapidly
.
The current clinical treatment is based on classic chemotherapy regimens, with a high recurrence rate and a poor overall prognosis.
According to relevant Chinese studies, the 5-year OS of domestic PTCL patients is less than 50%
.
September 15, 2021 is the eighteenth "World Lymphoma Awareness Day".
The theme of this year's "World Lymphoma Awareness Day" is "WE CAN'T WAIT".
With the trial of new drug combination therapy and autologous stem cell transplantation ( ASCT) consolidation therapy brings hope to patients with lymphoma
.
Selinexor (ATG-010) is the world's first approved oral selective nuclear export protein inhibitor (SINE).
The drug is currently undergoing phase I clinical trials in PTCL
.
On this occasion, Yimaitong cordially invites Professor Huang Huiqiang from Sun Yat-sen University Cancer Hospital to accept an interview to share his experience in the treatment of relapsed/refractory (R/R) PTCL with Celiniso! The R/R PTCL case introduced the patient, a 54-year-old female, with no special medical history
.
In June 2017, the patient went to the local hospital for “the right inguinal mass was found for 1 week”.
The biopsy pathology showed that: lymphoid follicular hyperplasia lesions, considering chronic non-specific lymphadenitis, need to be differentiated from low-grade lymphoma
.
No anti-tumor treatment was given, and the mass gradually increased afterwards.
In March 2018, a biopsy at Zhongshan No.
1 Hospital revealed PTCL (right inguinal lymph node) and lymphoepithelioid cell variant (Lennert lymphoma)
.
Right inguinal lymph node resection and biopsy were diagnosed as PTCL, considering lymphoepithelioid cell variants (Lennert lymphoma); immunohistochemistry: CD3+, CD4+, CD10-, TIA-1-, Bcl-6-, CD56-, EBER scattered +, TCR rearrangement+
.
Clinical diagnosis: First-line treatment of PTCL IIIB from April 2018 to August 2018.
EPOCH regimen.
After a total of 6 courses and 2 courses, the effect reached complete remission (CR), after which the mass increased.
Second-line treatment November 2018 to January 2019 Gemcitabine + Chidamide, a total of 2 courses of patients were evaluated as partial remission (PR) third-line treatment.
From April 2019 to October 2019, mitoxantrone liposomes as a single agent, a total of 6 courses and 2 courses, the patient reached CR , The largest lymph node was reduced from 3.
1*1.
6cm to 1.
4*1cm; after that, the tumor continued to be controlled by the fourth-line treatment of ADG106 from July 2020 to September 2020.
A total of 4 courses of curative effect were disease progression (PD).
Remission but not long-term maintenance, ADG106 new drug treatment is ineffective.
Five-line treatment: from October 2020 to August 2021 Celiniso combined with gemcitabine and oxaliplatin (GEMOX), a total of 3 courses; Celiniso single-agent maintenance , A total of 5 courses; the best curative effect is CR, and the progression-free survival (PFS) is> 9 months
.
(See the table below) After 2 courses, the patient's re-examination and evaluation of the efficacy reached CR.
After 4 courses, the CR efficacy continued after 6 courses.
There were repeated ANC and PLT declines during the single-drug treatment, and the dose of Celiniso had been decreased and repeated.
Interrupted, the PETCT evaluated PD by the 8th course of treatment, and the treatment was discontinued (August 2021)
.
The patient's five-line treatment of Celinisole medication dose and efficacy evaluation (left) before treatment; (right) after two courses of treatment (left) before treatment; (right) after two courses of treatment, it is concluded that the patient has received 4-line treatment in the past.
For patients with PTCL who are refractory to the end-line, complete remission was achieved after 2 courses of Celiniso combined with GEMOX regimen
.
After 3 courses of combined treatment, Celinisol was given single-agent maintenance treatment.
The patient's PFS was >9 months, and a good effect was achieved
.
Professor Huang Huiqiang commented that peripheral T-cell lymphoma is a highly aggressive non-Hodgkin's lymphoma in the clinic.
After first-line treatment, the overall prognosis is poor and the recurrence rate is high, especially R/R PTCL
.
This year’s "World Lymphoma Awareness Day" theme "WE CAN'T WAIT" reflects the overall attitude towards PTCL treatment-more aggressive, in recent years, with a variety of new anti-tumor drugs such as SINE, histone deacetylase Inhibitors and monoclonal antibody drugs have emerged in the treatment of PTCL, bringing new hopes for long-term survival to R/R PTCL patients
.
Celiniso is the first SINE compound approved by the FDA.
It is characterized by causing the nuclear storage and activation of tumor suppressor proteins and other growth regulator proteins, down-regulating a variety of oncogenic proteins, and inducing a large number of entities and proteins in vitro and in vivo.
Apoptosis of hematological tumor cells, while normal cells are not affected, a variety of treatment options for the treatment of multiple myeloma and diffuse large B-cell lymphoma have been included in the NCCN guidelines
.
In the clinical trial of R/R PTCL, Celinisole combined with GEMOX produced a synergistic effect.
Compared with GEMOX alone, the patient's efficacy was significantly improved and the side effects were tolerable.
The patient's PFS>9 months has exceeded the recurrence/ The usual PFS benefit (3-6 months) of refractory PTCL is an innovative clinical practice of a new targeted drug combined with conventional chemotherapy.
The national multi-center clinical study initiated by this combination is still in progress, and new results will be available soon.
It is hoped that Celiniso can bring survival benefits to more PTCL patients in the future
.
Professor Huang Huiqiang, Chief Physician, Professor, and Doctoral Supervisor, Deputy Director, Department of Internal Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University Cancer Hospital Chief Expert of Lymphoma, Chairman of the Lymphoma Professional Committee of the Chinese Geriatric Healthcare Association, CSCO Vice Chairman of the Chinese Anti-Lymph Alliance CSCO Thyroid Cancer Committee Chairman, Chinese Anti-Cancer Association Lymphoma Professional Committee, Vice Chairman, Chinese Anti-Cancer Association Lymphoma Professional Committee, Youth Committee, Chairman, Guangdong Anti-Cancer Association, Hematology and Oncology Professional Committee Honorary Chairman, Guangdong Provincial Society of Integrated Traditional Chinese and Western Medicine, Hematology Professional Committee, Deputy Chairman Poke "read the original text", we make progress together
It is clinically highly aggressive and the disease progresses rapidly
.
The current clinical treatment is based on classic chemotherapy regimens, with a high recurrence rate and a poor overall prognosis.
According to relevant Chinese studies, the 5-year OS of domestic PTCL patients is less than 50%
.
September 15, 2021 is the eighteenth "World Lymphoma Awareness Day".
The theme of this year's "World Lymphoma Awareness Day" is "WE CAN'T WAIT".
With the trial of new drug combination therapy and autologous stem cell transplantation ( ASCT) consolidation therapy brings hope to patients with lymphoma
.
Selinexor (ATG-010) is the world's first approved oral selective nuclear export protein inhibitor (SINE).
The drug is currently undergoing phase I clinical trials in PTCL
.
On this occasion, Yimaitong cordially invites Professor Huang Huiqiang from Sun Yat-sen University Cancer Hospital to accept an interview to share his experience in the treatment of relapsed/refractory (R/R) PTCL with Celiniso! The R/R PTCL case introduced the patient, a 54-year-old female, with no special medical history
.
In June 2017, the patient went to the local hospital for “the right inguinal mass was found for 1 week”.
The biopsy pathology showed that: lymphoid follicular hyperplasia lesions, considering chronic non-specific lymphadenitis, need to be differentiated from low-grade lymphoma
.
No anti-tumor treatment was given, and the mass gradually increased afterwards.
In March 2018, a biopsy at Zhongshan No.
1 Hospital revealed PTCL (right inguinal lymph node) and lymphoepithelioid cell variant (Lennert lymphoma)
.
Right inguinal lymph node resection and biopsy were diagnosed as PTCL, considering lymphoepithelioid cell variants (Lennert lymphoma); immunohistochemistry: CD3+, CD4+, CD10-, TIA-1-, Bcl-6-, CD56-, EBER scattered +, TCR rearrangement+
.
Clinical diagnosis: First-line treatment of PTCL IIIB from April 2018 to August 2018.
EPOCH regimen.
After a total of 6 courses and 2 courses, the effect reached complete remission (CR), after which the mass increased.
Second-line treatment November 2018 to January 2019 Gemcitabine + Chidamide, a total of 2 courses of patients were evaluated as partial remission (PR) third-line treatment.
From April 2019 to October 2019, mitoxantrone liposomes as a single agent, a total of 6 courses and 2 courses, the patient reached CR , The largest lymph node was reduced from 3.
1*1.
6cm to 1.
4*1cm; after that, the tumor continued to be controlled by the fourth-line treatment of ADG106 from July 2020 to September 2020.
A total of 4 courses of curative effect were disease progression (PD).
Remission but not long-term maintenance, ADG106 new drug treatment is ineffective.
Five-line treatment: from October 2020 to August 2021 Celiniso combined with gemcitabine and oxaliplatin (GEMOX), a total of 3 courses; Celiniso single-agent maintenance , A total of 5 courses; the best curative effect is CR, and the progression-free survival (PFS) is> 9 months
.
(See the table below) After 2 courses, the patient's re-examination and evaluation of the efficacy reached CR.
After 4 courses, the CR efficacy continued after 6 courses.
There were repeated ANC and PLT declines during the single-drug treatment, and the dose of Celiniso had been decreased and repeated.
Interrupted, the PETCT evaluated PD by the 8th course of treatment, and the treatment was discontinued (August 2021)
.
The patient's five-line treatment of Celinisole medication dose and efficacy evaluation (left) before treatment; (right) after two courses of treatment (left) before treatment; (right) after two courses of treatment, it is concluded that the patient has received 4-line treatment in the past.
For patients with PTCL who are refractory to the end-line, complete remission was achieved after 2 courses of Celiniso combined with GEMOX regimen
.
After 3 courses of combined treatment, Celinisol was given single-agent maintenance treatment.
The patient's PFS was >9 months, and a good effect was achieved
.
Professor Huang Huiqiang commented that peripheral T-cell lymphoma is a highly aggressive non-Hodgkin's lymphoma in the clinic.
After first-line treatment, the overall prognosis is poor and the recurrence rate is high, especially R/R PTCL
.
This year’s "World Lymphoma Awareness Day" theme "WE CAN'T WAIT" reflects the overall attitude towards PTCL treatment-more aggressive, in recent years, with a variety of new anti-tumor drugs such as SINE, histone deacetylase Inhibitors and monoclonal antibody drugs have emerged in the treatment of PTCL, bringing new hopes for long-term survival to R/R PTCL patients
.
Celiniso is the first SINE compound approved by the FDA.
It is characterized by causing the nuclear storage and activation of tumor suppressor proteins and other growth regulator proteins, down-regulating a variety of oncogenic proteins, and inducing a large number of entities and proteins in vitro and in vivo.
Apoptosis of hematological tumor cells, while normal cells are not affected, a variety of treatment options for the treatment of multiple myeloma and diffuse large B-cell lymphoma have been included in the NCCN guidelines
.
In the clinical trial of R/R PTCL, Celinisole combined with GEMOX produced a synergistic effect.
Compared with GEMOX alone, the patient's efficacy was significantly improved and the side effects were tolerable.
The patient's PFS>9 months has exceeded the recurrence/ The usual PFS benefit (3-6 months) of refractory PTCL is an innovative clinical practice of a new targeted drug combined with conventional chemotherapy.
The national multi-center clinical study initiated by this combination is still in progress, and new results will be available soon.
It is hoped that Celiniso can bring survival benefits to more PTCL patients in the future
.
Professor Huang Huiqiang, Chief Physician, Professor, and Doctoral Supervisor, Deputy Director, Department of Internal Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University Cancer Hospital Chief Expert of Lymphoma, Chairman of the Lymphoma Professional Committee of the Chinese Geriatric Healthcare Association, CSCO Vice Chairman of the Chinese Anti-Lymph Alliance CSCO Thyroid Cancer Committee Chairman, Chinese Anti-Cancer Association Lymphoma Professional Committee, Vice Chairman, Chinese Anti-Cancer Association Lymphoma Professional Committee, Youth Committee, Chairman, Guangdong Anti-Cancer Association, Hematology and Oncology Professional Committee Honorary Chairman, Guangdong Provincial Society of Integrated Traditional Chinese and Western Medicine, Hematology Professional Committee, Deputy Chairman Poke "read the original text", we make progress together
