Disease-oriented treatment of T/NK-cell lymphomas

Recent clinical trials for T/NK-cell lymphomas are summarized herein, focusing on ATL and extranodal NK/T-cell lymphoma (ENKL). The outcomes of patients with these malignancies were the poorest among various peripheral T-cell lymphomas (PTCLs) in the International T-Cell Lymphoma Project. JCOG has conducted several clinical trials aimed at improving these poor outcomes. For aggressive ATL, JCOG is conducting a phase II trial of VCAP-AMP-VECP followed by allogeneic SCT. For localized ENKL, concurrent chemoradiotherapy has shown promising and durable efficacy in the phase I/II study. Among various new agents for PTCLs and ATL, mogamulizumab has shown promising efficacy for relapsed ATL. A subsequent phase II study of mogamulizumab using the same dose and schedule for relapsed PTCL/CTCL also showed promising efficacy. To establish a new standard for untreated aggressive ATL, a randomized phase II study of VCAP-AMP-VECP with or without mogamulizumab was conducted. Higher % CR was obtained (52% vs 33%) in the former arm, suggesting that VCAP-AMP-VECP plus mogamulizumab is a reasonable option. Lenalidomide recently showed promising efficacy for ATL in phase I and II studies.