Dr Skrypets on an Analysis of Clinical Features of Older Patients With PTCL

“We still have a lack of data, and we need more targeted agents to improve patient outcomes. Unfortunately, [for treatment] implementation in clinical practice, we have only really simple clinical parameters which can predict survival outcomes.”

Tetiana Skrypets, MD, PhD, a clinical research physician in hematology in the Hematology and Cell Therapy Unit at the Istituto Tumori “Giovanni Paolo II,” discussed the design and future implications of a real-world study that described the clinical features and treatment outcomes of older patients with peripheral T-cell lymphomas (PTCL).

This study aimed to establish a benchmark for the optimal treatment of older patients with PTCL and included data from patients at least 65 years of age who were included in the prospective international registry T-Cell Projects 1.0 and 2.0. This real-world study analyzed 922 cases of PTCL from the T-Cell Projects.

The real-world study investigators conducted both univariate and multivariate analyses. Notably, basic clinical parameters like chronological age, unintentional weight loss, and performance status were found to be significant in identifying patients with high-risk disease, according to Skrypets. These easily assessable factors may contribute meaningfully to prognostication in this population, she said.

Furthermore, no differences in clinical PTCL presentation were observed between patients 65 to 74 years of age and those at least 75 years of age. Overall, this study showed that fit, older patients with PTCL can be treated with regimens used in younger patients. However, older patients with high-risk PTCL continue to have poor outcomes.

Validation of the prognostic parameters for high-risk PTCL remains necessary, Skrypets emphasized. Although investigators are actively seeking a suitable external validation cohort, Skrypets anticipates that identifying an appropriate dataset may pose challenges. Nonetheless, efforts are ongoing, and future analyses may help establish a validated prognostic scoring system, she explained. Those data may be presented at upcoming medical congresses, she noted.

Additionally, there is a pressing need for more comprehensive therapeutic data in T-cell lymphomas, which continues to represent a notable gap in oncologic understanding globally, Skrypets stated. Currently, therapeutic options for these patients remain limited, she reported. For example, brentuximab vedotin (Adcetris)–based regimens have contributed to improved outcomes in some subsets of patients with T-cell lymphoma; however, these benefits are not uniformly distributed across all disease subtypes, she cautioned. Overall, despite some progress, hematologists remain limited to using only rudimentary clinical indicators to guide prognostication and treatment decisions in T-cell lymphoma, she concluded.