KEY TAKEAWAYS
- The study aimed to assess chidamide plus CHOP vs. CHOP alone in newly diagnosed AITL and examined transplantation impact.
- Results suggested chidamide + CHOP may improve prognosis in treatment-naive AITL, with auto-HSCT enhancing survival.
Angioimmunoblastic T-cell lymphoma (AITL) is characterized by a poor survival prognosis. While chidamide has demonstrated efficacy in relapsed/refractory AITL, its role in the newly diagnosed setting remains unclear.
Xiangping Zong and the team aimed to evaluate the efficacy and safety of chidamide combined with doxorubicin, cyclophosphamide, prednisone, and vincristine (CHOP) compared to CHOP alone in newly diagnosed patients with AITL and to investigate the impact of transplantation.
The study retrospectively compared outcomes between patients receiving chidamide + CHOP in a clinical trial and historical controls treated with CHOP alone. About 66 treatment-naive patients with AITL diagnosed between April 2014 and November 2022 were included, with 33 receiving chidamide + CHOP and 33 receiving CHOP alone.
Clinical characteristics were balanced between the groups, and all patients were scheduled for up to 6 treatment courses before transplantation.
The chidamide group exhibited significantly longer median overall survival (OS) compared to the control group (median OS not reached vs. 20 months, P= 0.002). Median progression-free survival (PFS) was longer in the chidamide group (22 months) than the control group (11 months), but this difference was not statistically significant (P= 0.080).
Notably, in the high-risk group (International Prognostic Index [IPI] ≥ 3), the chidamide group showed significantly superior complete response (CR) and overall response rates (ORR) compared to the control group (P= 0.002, P= 0.034).
The chidamide group’s PFS and OS in this high-risk cohort were not reached, significantly differing from the control group (P= 0.007, P= 0.003). Transplanted patients demonstrated longer median OS than non-transplanted patients (P= 0.004). Multivariate analysis indicated that the chidamide group had a reduced risk of death across the entire cohort.
The study concluded that, due to its non-random and retrospective nature, chidamide combined with chemotherapy should be tested in randomized trials for its potential to improve prognosis in treatment-naive patients with AITL. Additionally, autologous hematopoietic stem cell transplantation (auto-HSCT) has shown enhanced OS in these individuals.
Funding support was provided by the National Natural Science Foundation of China (82020108003), the National Key R & D Program of China (2022YFC2502700), and the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD) Suzhou Science and Technology Program Project (SLT201911).
Source: https://pubmed.ncbi.nlm.nih.gov/39229263/
Zong X, Yang Z, Zhou J, et al. (2024). “Clinical trial: Chidamide plus CHOP improve the survival of newly diagnosed angioimmunoblastic T-cell lymphoma.” Front Immunol. 2024;15:1430648. Published 2024 Aug 20. doi:10.3389/fimmu.2024.1430648
