OWEN(O’CONNOR((NEW(YORK)(
(
FIRST(LINE(TREATMENT(
(
American(Cancer(Society(Research(Professor(
University(of(Virginia(Cancer(Center(
!
The! peripheral! T>cell! lymphomas! (PTCL)! represent! a! very! heterogenous! and! rare! group! of!
malignancies.! They! are! thought! to! account! for! only! 10>15%! of! all! cases! of! non>Hodgkin!
lymphoma!in!the!U.S.,!with!nearly!30!discrete!subtypes!recognized!by!the!WHO!Classification!
of!Hematologic!Neoplasms.!Two!subtypes!account!for!the!bulk!of!cases,!including!PTCL>NOS!
and!Angioimmunoblastic!T>cell!lymphoma,!which!account!for!approximately!2,500!and!1,800!
cases!per!year!in!the!U.S.!Most!other!subtypes!have!an!incidence!measured!at!1000!cases!
per!year!or!less.!!
!
This! rarity! and! diversity! of! the! PTCL! has! no! doubt! contributed! to! the! enormous! confusion!
that!arises!when!it!comes!to!making!upfront!treatment!recommendations.!!While!CHOP!or!
CHOEP!based!chemotherapy!is!widely!regarded!as!the!standard!of!care,!it!is!also!clear!that!
these! conventional! chemotherapy! regimens! produce! long>term! survival! in! only! 20>25%! of!
patients.!!Over!the!years,!the!prospect!of!autologous!stem!cell!transplant!in!first!complete!
remission! (CR)! has! received! much! attention,! and! is! a! consideration! in! every! transplant!
eligible! patients,! despite! the! lack! of! any! definitive! randomized! clinical! trial! data.! ! Most!
recently,! results! of! the! ECHELON>2! clinical! trial! have! established! the! merits! of! integrating!
Brentuximab! vedotin! (Bv)! into! a! standard! CHOP! based! backbone.! ! While! these! data! have!
convincingly! established! that! Bv>CHOP! is! superior! to! CHOP! for! patients! with! CD30>positive!
analplastic!large!cell!lymphoma,!it!is!not!entirely!clear!if!that!benefit!is!sustained!in!patients!
with!other!subtypes!of!ALCL.!
!
In!addition!to!the!conventional!combination!chemotherapy!approaches,!it!is!also!clear!that!
novel! epigenetic! based! combination! and! immunoepigenetic! doublets! and! triplets! can!
produce! meaningful! clinical! responses! and! durable! remissions! that! appear! to! rival! the!
outcomes! seen! with! chemotherapy,! especially! in! the! relapsed! setting.! Albeit! early,! a!
gradually! amassing! experience! has! begun! to! demonstrate! that! novel! :! novel! combinations!
predicated! on! these! immunoepigenetic! backbones! can! be! used! as! a! bridge! to! autologous!
stem! cell! transplant! (ASCT)! for! those! in! the! front>line! setting,! and! produce! prolonged!
progression!free!survivals!(PFS)!among!patients!with!relapsed!or!refractory!disease.!
!
During! this! exercise,! we! will! discuss! the! advantages! and! disadvantages! of! the! many!
emerging!options!now!available!to!treat!patients!with!PTCL,!with!a!particular!emphasis!on!
the!front>line!treatment!of!patients!with!angioimmunoblastic!T>cell!lymphoma.!!
!
! !
SCIENTIFIC PROGRAMME
SESSION I
HODGKIN’S DISEASE
DEBATE I
IS THERE STILL A ROLE
FOR COMBINED MODALITY
THERAPY FOR EARLY
STAGE CHL?
SESSION II
T-CELL LYMPHOMA
ROUNDTABLE I
FUTURE DIRECTIONS IN
T-CELL LYMPHOMA
SESSION III
FOLLICULAR LYMPHOMA
DEBATE II
CAN WE AVOID
CHEMOTHERAPY IN
THE MANAGEMENT OF
FOLLICULAR LYMPHOMA?
SESSION IV
RARE LYMPHOMAS –
MARGINAL ZONE
LYMPHOMA AND
WALDENSTRÖM M
ACROGLOBULINEMIA
ROUNDTABLE II – WHERE
TO GO IN RARE B-CELL
LYMPHOMAS
SESSION V
MANTLE CELL LYMPHOMA
SESSION VI
DIFFUSE LARGE B-CELL
LYMPHOMA
DEBATE III
DO WE STILL NEED ASCT
IN MCL?
SESSION VII
NOVEL THER APEUTIC
CONCEPTS IN B-CELL
LYMPHOMAS
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES