Abstract
Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of aggressive non-Hodgkin lymphomas. Angioimmunoblastic T-cell lymphoma (AITL) is a common subtype of PTCL, and patients with AITL typically have a poor prognosis with limited treatment options. Clinical studies have demonstrated the activity of romidepsin, a structurally unique, potent, bicyclic class 1 selective histone deacetylase inhibitor, in patients with relapsed or refractory AITL. In the case presented herein, we describe a patient treated with single-agent romidepsin at first diagnosis of AITL, resulting in complete remission for over 2 years and leading to the use of maintenance dosing. The patient eventually underwent a successful autologous stem cell transplant. This case illustrates the successful use of romidepsin for the long-term treatment of a patient with AITL in a clinical setting. Maintenance dosing may be an option for patients who have an extended response to romidepsin in order to optimize outcomes and to prolong time to the next subsequent line of therapy. In our case, the patient was able to remain in complete remission for more than 1 year while receiving maintenance dosing of romidepsin.
Highlights
Peripheral T-cell lymphomas (PTCLs) are a diverse group of aggressive T-cell and natural killer-cell malignancies associated with poor prognosis [1, 2]
The epigenetic modifying agent romidepsin is a structurally unique, potent, bicyclic class I selective histone deacetylase inhibitor [6,7,8] approved by the US Food and Drug Administration for the treatment of patients with PTCL who had received ≥1 prior therapy and patients with cutaneous T-cell lymphoma (CTCL) who had received ≥1 prior systemic therapy [9]
There are no current guidelines in place for prolonged use of romidepsin in a clinical setting, an observational study to examine the long-term use of romidepsin in patients with CTCL is under way (NCT02296398)
Summary
Peripheral T-cell lymphomas (PTCLs) are a diverse group of aggressive T-cell and natural killer-cell malignancies associated with poor prognosis [1, 2]. The epigenetic modifying agent romidepsin is a structurally unique, potent, bicyclic class I selective histone deacetylase inhibitor [6,7,8] approved by the US Food and Drug Administration for the treatment of patients with PTCL who had received ≥1 prior therapy and patients with cutaneous T-cell lymphoma (CTCL) who had received ≥1 prior systemic therapy [9]. The trial protocol was amended to allow (but not mandate) patients treated for ≥12 cycles to receive maintenance dosing of 2 rather than 3 doses per 28-day cycle [11]. Patients treated for ≥24 cycles who had received 2 doses per cycle for ≥6 cycles could be treated at maintenance dosing of 1 dose per cycle [11]. There are no current guidelines in place for prolonged use of romidepsin in a clinical setting, an observational study to examine the long-term use of romidepsin in patients with CTCL is under way (NCT02296398)
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