SOHO 2023 | Key challenges and unmet needs in PTCL
Jasmine Zain, MD, City of Hope, Duarte, CA, discusses key challenges and unmet needs in peripheral T-cell lymphoma (PTCL), including the lack of curative treatment options and suitable disease models for pre-clinical efficacy and safety assessment. This interview took place at the Eleventh Annual Meeting of the Society of Hematologic Oncology (SOHO 2023) held in Houston, TX.
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Transcript (edited for clarity)
So PTCL is not one disease- it’s actually over 25 different diseases. It’s basically the name given to T-cell lymphomas that arise from mature T-cells that mature in the thymus and then go into our different lymphoid organs. There are a lot of unmet needs. First of all, we don’t really have good treatments that are curative for this disease, so the research is ongoing and needed for defining better treatment options for these patients...
So PTCL is not one disease- it’s actually over 25 different diseases. It’s basically the name given to T-cell lymphomas that arise from mature T-cells that mature in the thymus and then go into our different lymphoid organs. There are a lot of unmet needs. First of all, we don’t really have good treatments that are curative for this disease, so the research is ongoing and needed for defining better treatment options for these patients. The outcomes for most subtypes in five years is about 30%. So, that in itself is a very dismal figure. When you tell that to the patients, they get very upset and anxious, understandably so. The main need is to try to find treatments. The other big challenge is that they are rare and they’re heterogeneous. They’re not one disease. So, trying to do clinical trials that are meaningful, that require large numbers of patients is a huge challenge. We have to collaborate with our colleagues, sometimes internationally, to get the number of patients needed for these trials, to answer some very important questions. Some of the biggest trials that have happened in this disease have included 200-300 patients in each arm, which is nothing for something like breast cancer, for example, or other diseases- even B-cell lymphomas. But for T-cell lymphoma, for us, those are the gold standard trials. So those are some of the really big issues. The other problem is animal models, and getting pre-clinical data is also limited. There have been several challenges in trying to get adequate animal models for this disease, as these cells don’t grow easily. It’s not just the cancer cell, it’s the microenvironment that has to be recapitulated in the model, which has been difficult and challenging. But there are a few centers now that have some animal models, even PDX models that are useful for at least checking some preliminary drug combinations for efficacy or synergy. This is a group of diseases that require collaboration between centers, resources that need to be pooled. We also have to beg drug companies and pharmaceutical companies to allow us to do these studies and give us the drugs and the resources to do these studies, because it’s not a huge market. So at least in my opinion, these are the major challenges.
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