From empiric to mechanism-based therapy for peripheral T cell lymphoma

Peripheral T cell lymphoma (PTCL) represents a heterogeneous group of mature T and natural killer cell-derived neoplasms, comprising approximately 10 % of non-Hodgkin lymphoma. Although at least 20 distinct histologic subtypes of PTCL have been identified, the historical treatment approach has been uniform application of anthracycline-based combination chemotherapy, resulting in significantly inferior outcomes compared to B-cell non-Hodgkin lymphoma. Because of the generally poor outcomes with conventional chemotherapy, PTCL represents an unmet medical need, therefore providing the opportunity to evaluate novel agents. Herein, we will review the evolving treatment strategies for PTCL, discuss how different treatment approaches impact the underlying biology of PTCL, and speculate on future targets for therapeutic intervention. We conclude that future efforts to develop effective therapies for PTCL will benefit from a biomarker-driven strategy rather than histologic classification.