Clinical trials update from the 15th ICML

Focus on... T-cell lymphomas

Stethoscope

The 15th International Conference of Malignant Lymphoma (ICML) took place in Lugano, Switzerland, in June 2019. In the latest issue of Lymphoma Matters, we catch up with some of the lymphoma experts who attended to find out the latest news in lymphoma research.

Here we focus on T-cell lymphomas: 

T-cell lymphomas are rare, accounting for around 10% to 15% of non-Hodgkin lymphomas. Progress in improving outcomes in T-cell lymphoma has historically been disappointing but some clinical trials presented over the last few months and at ICML offer potential new options for people with T-cell lymphomas.

Brentuximab vedotin, an antibody–drug conjugate that targets a protein called CD30, is improving outcomes in T-cell lymphomas and could change the way some T-cell lymphomas are treated.

  • The ALCANZA study found that brentuximab vedotin was more effective than common current treatments for T-cell skin lymphoma. This has led to brentuximab vedotin being made available on the NHS for people with advanced T-cell skin lymphomas that make the CD30 protein.
  • The ECHELON-2 study found that replacing the vincristine (Oncovin®) component of CHOP with brentuximab vedotin resulted in a 34% reduction in death from peripheral T-cell lymphomas. As a result, brentuximab vedotin is now being evaluated by NICE for first-line treatment of people with peripheral T-cell lymphomas.

Also going through the NICE appraisal process is mogamulizumab, an antibody therapy that targets a protein called CCR4 on T cells. The MAVORIC study found it offered significant benefits over traditional treatment with vorinostat for people with relapsed or refractory T-cell skin lymphomas. It was granted a European licence for the treatment of adults with relapsed or refractory mycosis fungoides or Sézary syndrome in November 2018. The NICE appraisal process is ongoing.

A phase 2 trial called TELLOMAK has recently opened in people with advanced T-cell lymphomas. It is testing a new antibody therapy called IPH4102, which targets a protein on T cells called KIR3DL2. An early trial of IPH4102 in T-cell skin lymphoma had promising results. Laboratory studies suggest that the efficacy of IPH4102 might be increased by giving it with the chemotherapy drugs gemcitabine and oxaliplatin (GEMOX). TELLOMAK is investigating IPH4102 in combination with GEMOX in peripheral T-cell lymphomas and on its own in T-cell skin lymphomas.

In an earlier phase of development is sintilimab, an antibody targeting a protein called PD-1. The ORIENT-4 study showed that around 2 in 3 people with relapsed or refractory extranodal NK/T-cell lymphoma responded to treatment with sintilimab. This could be a promising future treatment option.

 
These are exciting times with increasing biological insights in T-cell lymphoma research leading to new therapeutics that are leading to improved outcomes for those affected with many different T-cell lymphomas.
Professor Tim Illidge, Professor Of Targeted Therapy And Oncology, The Christie Hospital, Manchester.

To find out more about clinical trials for lymphoma, or to search for a trial that might be suitable for you, visit Lymphoma TrialsLink.

21 October 2019