Patients with the T-follicular helper cell subtype of peripheral T-cell lymphoma showed more favorable outcomes when treated with romidepsin plus CHOP (Ro-CHOP) versus CHOP alone, according to the final analysis of the phase III Ro-CHOP randomized trial, published in the Journal of Clinical Oncology.
Lead author Vincent Camus, MD, PhD, of the Centre Henri Becquerel in Rouen, France, noted that the study’s primary analysis previously reported that Ro-CHOP did not show improved efficacy compared with CHOP alone in the first-line treatment of overall patients with peripheral T-cell lymphoma.
However, in the planned final analysis at year five, with a median follow-up of six years, the median progression-free survival (PFS) was 12.0 months and 10.2 months (hazard ratio [HR], 0.79; 95% CI, 0.620-1.005; P=.54) with Ro-CHOP and CHOP, respectively, and the median overall survival (OS) was 62.2 months (range, 35.7-86.6 months) and 43.8 months (range, 30.1-70.2 months; HR, 0.88; 95% CI, 0.68-1.14; P=.324), respectively.
The authors noted exploratory analysis found that median PFS in the follicular helper T-cell lymphoma subgroups was significantly longer with Ro-CHOP at 19.5 months versus 10.6 months with CHOP (HR, 0.703; 95% CI, 0.502-0.985; P=.039).
Additionally, 251 patients who received second-line treatments had a median PFS and OS after relapse or progression of 3.31 months and 11.5 months, respectively. “Within the limits of highly heterogeneous second-line treatments, no specific regimen seemed to provide superior disease control,” Dr. Camus and colleagues stated.
However, brentuximab vedotin in association with chemotherapy showed a potential benefit for PFS, “even after excluding anaplastic large-cell lymphoma subtype or adjusting for histology and International Prognostic Index in a multivariate model (HR, 0.431; 95% CI, 0.238-0.779; P=.005),” Dr. Camus and colleagues ended.
Reference
Camus V, Thieblemont C, Gaulard P, et al. Romidepsin plus cyclophosphamide, doxorubicin, vincristine, and prednisone versus cyclophosphamide, doxorubicin, vincristine, and prednisone in patients with previously untreated peripheral T-cell lymphoma: final analysis of the Ro-CHOP trial. J Clin Oncol. 2024;42(14):1612-1618. doi:10.1200/JCO.23.01687