Barbarotta Lisa, Hurley Kristen
1Hematology-Oncology Service, Smilow Cancer Hospital, Yale New Haven, Connecticut; 2Avera Medical Group, Hematology and Bone Marrow Transplantation, Sioux Falls, South Dakota.
J Adv Pract Oncol. 2015 Jan-Feb;6(1):22-36.
Peripheral T-cell lymphomas (PTCLs) are a rare, heterogeneous group of T-cell- or natural killer cell-derived non-Hodgkin lymphomas. The majority of patients with PTCL experience an aggressive disease course and poor overall survival. Historically, PTCL has been treated with chemotherapy regimens used to treat B-cell lymphomas; however, a lack of durable responses to frontline therapies and few effective options for salvage treatment have led to the development of newer therapies. Romidepsin is a structurally unique, potent, bicyclic class 1 selective histone deacetylase (HDAC) inhibitor that has demonstrated durable clinical responses in patients with relapsed/refractory PTCL, leading to its approval by the US Food and Drug Administration in 2011 for the treatment of PTCL in patients who have received at least one prior therapy. Here, the authors provide an overview of PTCL, review the role of HDAC inhibitors as anticancer agents, discuss romidepsin use in PTCL, and highlight considerations for advanced practitioners (including the management of side effects).
外周T细胞淋巴瘤(PTCL)是一组罕见的、异质性的T细胞或自然杀伤细胞来源的非霍奇金淋巴瘤。大多数PTCL患者经历侵袭性病程且总生存期较差。从历史上看,PTCL一直采用用于治疗B细胞淋巴瘤的化疗方案进行治疗;然而,对一线治疗缺乏持久反应以及挽救治疗的有效选择较少,导致了更新疗法的发展。罗米地辛是一种结构独特、强效的双环1类选择性组蛋白去乙酰化酶(HDAC)抑制剂,已在复发/难治性PTCL患者中显示出持久的临床反应,这使其在2011年获得美国食品药品监督管理局批准,用于治疗至少接受过一种先前治疗的PTCL患者。在此,作者提供了PTCL的概述,回顾了HDAC抑制剂作为抗癌药物的作用,讨论了罗米地辛在PTCL中的应用,并强调了高级从业者的注意事项(包括副作用的管理)。