Outcomes for Relapsed and Refractory Peripheral T-Cell Lymphoma Patients after Front-Line Therapy from the COMPLETE Registry

Frederick Lansigan; Steven M. Horwitz; Lauren C. Pinter-Brown; Steven T. Rosen; Barbara Pro; Eric D. Hsi; Massimo Federico; Christian Gisselbrecht; Marc Schwartz; Lisa A. Bellm; Mark Acosta; Andrei R. Shustov; Ranjana H. Advani; Tatyana Feldman; Mary Jo Lechowicz; Sonali M. Smith; Anil Tulpule; Michael D. Craig; John P. Greer; Brad S. Kahl; Joseph W. Leach; Neil Morganstein; Carla Casulo; Steven I. Park; Francine M. Foss

doi:10.1159/000500666

Outcomes for Relapsed and Refractory Peripheral T-Cell Lymphoma Patients after Front-Line Therapy from the COMPLETE Registry

Frederick Lansigan, Steven M. Horwitz, Lauren C. Pinter-Brown, Steven T. Rosen, Barbara Pro, Eric D. Hsi, Massimo Federico, Christian Gisselbrecht, Marc Schwartz, Lisa A. Bellm, Mark Acosta, Andrei R. Shustov, Ranjana H. Advani, Tatyana Feldman, Mary Jo Lechowicz, Sonali M. Smith, Anil Tulpule, Michael D. Craig, John P. Greer, Brad S. KahlJoseph W. Leach, Neil Morganstein, Carla Casulo, Steven I. Park, Francine M. Foss

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Abstract

Background: Outcomes for patients with peripheral T-cell lymphoma (PTCL) who fail to achieve complete response (CR) or relapse after front-line therapy are poor with lack of prospective outcomes data. Objectives: COMPLETE is a prospective registry of 499 patients enrolled at academic and community sites in the United States detailing patient demographics, treatment and outcomes for patients with aggressive T cell lymphomas. We report results for patients with primary refractory and relapsed disease. Methods: Primary refractory disease was defined as an evaluable best response to initial treatment (induction ± maintenance or consolidation/transplant) other than CR, and included a partial response, progressive disease, or no response/stable disease. Relapsed disease was defined as an evaluable best response to initial treatment of CR, followed by disease progression at a later date, irrespective of time to progression. Patients were included in the analysis if initial treatment began within 30 days of enrollment and treatment duration was ≥4 days. Results: Of 420 evaluable patients, 97 met the definition for primary refractory and 58 with relapsed disease. In the second-line setting, relapsed patients received single-agent therapies more often than refractory patients (52 vs. 28%; p = 0.01) and were more likely to receive single-agent regimens (74 vs. 53%; p = 0.03). The objective response rate to second-line therapy was higher in relapsed patients (61 vs. 40%; p = 0.04) as was the proportion achieving a CR (41 vs. 14%; p = 0.002). Further, relapsed patients had longer overall survival (OS) compared to refractory patients, with a median OS of 29.1 versus 12.3 months. Conclusions: Despite the availability of newer active single agents, refractory patients were less likely to receive these therapies and continue to have inferior outcomes compared to those with relapsed disease. PTCL in the real world remains an unmet medical need, and improvements in front-line therapies are needed.

Original language	English
Pages (from-to)	40-50
Number of pages	11
Journal	Acta Haematologica
Volume	143
Issue number	1
DOIs	https://doi.org/10.1159/000500666
State	Published - Jan 1 2020

Keywords

Combination
Drug therapy
Peripheral T-cell lymphoma
Prospective cohort studies
Salvage therapy

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Lansigan, F., Horwitz, S. M., Pinter-Brown, L. C., Rosen, S. T., Pro, B., Hsi, E. D., Federico, M., Gisselbrecht, C., Schwartz, M., Bellm, L. A., Acosta, M., Shustov, A. R., Advani, R. H., Feldman, T., Lechowicz, M. J., Smith, S. M., Tulpule, A., Craig, M. D., Greer, J. P., ... Foss, F. M. (2020). Outcomes for Relapsed and Refractory Peripheral T-Cell Lymphoma Patients after Front-Line Therapy from the COMPLETE Registry. Acta Haematologica, 143(1), 40-50. https://doi.org/10.1159/000500666

@article{dd16c10f3c1d45258f48cc27f4b7e8c2,

title = "Outcomes for Relapsed and Refractory Peripheral T-Cell Lymphoma Patients after Front-Line Therapy from the COMPLETE Registry",

abstract = "Background: Outcomes for patients with peripheral T-cell lymphoma (PTCL) who fail to achieve complete response (CR) or relapse after front-line therapy are poor with lack of prospective outcomes data. Objectives: COMPLETE is a prospective registry of 499 patients enrolled at academic and community sites in the United States detailing patient demographics, treatment and outcomes for patients with aggressive T cell lymphomas. We report results for patients with primary refractory and relapsed disease. Methods: Primary refractory disease was defined as an evaluable best response to initial treatment (induction ± maintenance or consolidation/transplant) other than CR, and included a partial response, progressive disease, or no response/stable disease. Relapsed disease was defined as an evaluable best response to initial treatment of CR, followed by disease progression at a later date, irrespective of time to progression. Patients were included in the analysis if initial treatment began within 30 days of enrollment and treatment duration was ≥4 days. Results: Of 420 evaluable patients, 97 met the definition for primary refractory and 58 with relapsed disease. In the second-line setting, relapsed patients received single-agent therapies more often than refractory patients (52 vs. 28%; p = 0.01) and were more likely to receive single-agent regimens (74 vs. 53%; p = 0.03). The objective response rate to second-line therapy was higher in relapsed patients (61 vs. 40%; p = 0.04) as was the proportion achieving a CR (41 vs. 14%; p = 0.002). Further, relapsed patients had longer overall survival (OS) compared to refractory patients, with a median OS of 29.1 versus 12.3 months. Conclusions: Despite the availability of newer active single agents, refractory patients were less likely to receive these therapies and continue to have inferior outcomes compared to those with relapsed disease. PTCL in the real world remains an unmet medical need, and improvements in front-line therapies are needed.",

keywords = "Combination, Drug therapy, Peripheral T-cell lymphoma, Prospective cohort studies, Salvage therapy",

author = "Frederick Lansigan and Horwitz, {Steven M.} and Pinter-Brown, {Lauren C.} and Rosen, {Steven T.} and Barbara Pro and Hsi, {Eric D.} and Massimo Federico and Christian Gisselbrecht and Marc Schwartz and Bellm, {Lisa A.} and Mark Acosta and Shustov, {Andrei R.} and Advani, {Ranjana H.} and Tatyana Feldman and Lechowicz, {Mary Jo} and Smith, {Sonali M.} and Anil Tulpule and Craig, {Michael D.} and Greer, {John P.} and Kahl, {Brad S.} and Leach, {Joseph W.} and Neil Morganstein and Carla Casulo and Park, {Steven I.} and Foss, {Francine M.}",

note = "Publisher Copyright: {\textcopyright} 2019 S. Karger AG, Basel.",

year = "2020",

month = jan,

day = "1",

doi = "10.1159/000500666",

language = "English",

volume = "143",

pages = "40--50",

journal = "Acta Haematologica",

issn = "0001-5792",

number = "1",

}

Lansigan, F, Horwitz, SM, Pinter-Brown, LC, Rosen, ST, Pro, B, Hsi, ED, Federico, M, Gisselbrecht, C, Schwartz, M, Bellm, LA, Acosta, M, Shustov, AR, Advani, RH, Feldman, T, Lechowicz, MJ, Smith, SM, Tulpule, A, Craig, MD, Greer, JP, Kahl, BS, Leach, JW, Morganstein, N, Casulo, C, Park, SI & Foss, FM 2020, 'Outcomes for Relapsed and Refractory Peripheral T-Cell Lymphoma Patients after Front-Line Therapy from the COMPLETE Registry', Acta Haematologica, vol. 143, no. 1, pp. 40-50. https://doi.org/10.1159/000500666

TY - JOUR

T1 - Outcomes for Relapsed and Refractory Peripheral T-Cell Lymphoma Patients after Front-Line Therapy from the COMPLETE Registry

AU - Lansigan, Frederick

AU - Horwitz, Steven M.

AU - Pinter-Brown, Lauren C.

AU - Rosen, Steven T.

AU - Pro, Barbara

AU - Hsi, Eric D.

AU - Federico, Massimo

AU - Gisselbrecht, Christian

AU - Schwartz, Marc

AU - Bellm, Lisa A.

AU - Acosta, Mark

AU - Shustov, Andrei R.

AU - Advani, Ranjana H.

AU - Feldman, Tatyana

AU - Lechowicz, Mary Jo

AU - Smith, Sonali M.

AU - Tulpule, Anil

AU - Craig, Michael D.

AU - Greer, John P.

AU - Kahl, Brad S.

AU - Leach, Joseph W.

AU - Morganstein, Neil

AU - Casulo, Carla

AU - Park, Steven I.

AU - Foss, Francine M.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background: Outcomes for patients with peripheral T-cell lymphoma (PTCL) who fail to achieve complete response (CR) or relapse after front-line therapy are poor with lack of prospective outcomes data. Objectives: COMPLETE is a prospective registry of 499 patients enrolled at academic and community sites in the United States detailing patient demographics, treatment and outcomes for patients with aggressive T cell lymphomas. We report results for patients with primary refractory and relapsed disease. Methods: Primary refractory disease was defined as an evaluable best response to initial treatment (induction ± maintenance or consolidation/transplant) other than CR, and included a partial response, progressive disease, or no response/stable disease. Relapsed disease was defined as an evaluable best response to initial treatment of CR, followed by disease progression at a later date, irrespective of time to progression. Patients were included in the analysis if initial treatment began within 30 days of enrollment and treatment duration was ≥4 days. Results: Of 420 evaluable patients, 97 met the definition for primary refractory and 58 with relapsed disease. In the second-line setting, relapsed patients received single-agent therapies more often than refractory patients (52 vs. 28%; p = 0.01) and were more likely to receive single-agent regimens (74 vs. 53%; p = 0.03). The objective response rate to second-line therapy was higher in relapsed patients (61 vs. 40%; p = 0.04) as was the proportion achieving a CR (41 vs. 14%; p = 0.002). Further, relapsed patients had longer overall survival (OS) compared to refractory patients, with a median OS of 29.1 versus 12.3 months. Conclusions: Despite the availability of newer active single agents, refractory patients were less likely to receive these therapies and continue to have inferior outcomes compared to those with relapsed disease. PTCL in the real world remains an unmet medical need, and improvements in front-line therapies are needed.

AB - Background: Outcomes for patients with peripheral T-cell lymphoma (PTCL) who fail to achieve complete response (CR) or relapse after front-line therapy are poor with lack of prospective outcomes data. Objectives: COMPLETE is a prospective registry of 499 patients enrolled at academic and community sites in the United States detailing patient demographics, treatment and outcomes for patients with aggressive T cell lymphomas. We report results for patients with primary refractory and relapsed disease. Methods: Primary refractory disease was defined as an evaluable best response to initial treatment (induction ± maintenance or consolidation/transplant) other than CR, and included a partial response, progressive disease, or no response/stable disease. Relapsed disease was defined as an evaluable best response to initial treatment of CR, followed by disease progression at a later date, irrespective of time to progression. Patients were included in the analysis if initial treatment began within 30 days of enrollment and treatment duration was ≥4 days. Results: Of 420 evaluable patients, 97 met the definition for primary refractory and 58 with relapsed disease. In the second-line setting, relapsed patients received single-agent therapies more often than refractory patients (52 vs. 28%; p = 0.01) and were more likely to receive single-agent regimens (74 vs. 53%; p = 0.03). The objective response rate to second-line therapy was higher in relapsed patients (61 vs. 40%; p = 0.04) as was the proportion achieving a CR (41 vs. 14%; p = 0.002). Further, relapsed patients had longer overall survival (OS) compared to refractory patients, with a median OS of 29.1 versus 12.3 months. Conclusions: Despite the availability of newer active single agents, refractory patients were less likely to receive these therapies and continue to have inferior outcomes compared to those with relapsed disease. PTCL in the real world remains an unmet medical need, and improvements in front-line therapies are needed.

KW - Combination

KW - Drug therapy

KW - Peripheral T-cell lymphoma

KW - Prospective cohort studies

KW - Salvage therapy

UR - http://www.scopus.com/inward/record.url?scp=85069761781&partnerID=8YFLogxK

U2 - 10.1159/000500666

DO - 10.1159/000500666

M3 - Article

C2 - 31315113

AN - SCOPUS:85069761781

SN - 0001-5792

VL - 143

SP - 40

EP - 50

JO - Acta Haematologica

JF - Acta Haematologica

IS - 1

ER -

Outcomes for Relapsed and Refractory Peripheral T-Cell Lymphoma Patients after Front-Line Therapy from the COMPLETE Registry

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Keywords

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