Pilot study for T-cell lymphoma finds adding epigenetic drug to standard chemotherapy is effective (88.2% cure rate adding azaciditine)

Medical Xpress / Weill Cornell Medical College / Blood ^ | May 4, 2023 | Jia Ruan et al

[ConservativeMind]

Nearly 90% of patients with an aggressive subtype of non-Hodgkin lymphoma had their cancer go into remission in a small phase 2 clinical trial testing a treatment aimed at making chemotherapy more effective, according to investigators.

The clinical trial included 17 patients with a type of blood cancer called peripheral T-cell lymphoma with T-follicular helper phenotype (PTCL-TFH), also known as angioimmunoblastic T-cell lymphoma. Fifteen of them (88.2%) had complete responses after a several-month course of treatment, which combined a standard four-drug chemotherapy regimen known as CHOP with another drug called azaciditine. Patients with PTCL-TFH have tumors that typically bear excessive clusters of gene-silencing marks called methylations on their DNA—marks that azacitidine removes.

A standard initial therapy for most lymphomas is a four-drug chemotherapy regimen (CHOP) that is usually delivered in six three-week cycles.

Azacitidine, currently approved for myelodysplastic syndrome and some leukemias, works to remove gene-regulating marks on DNA called methylations. Many aggressive cancers harbor dense patches of these DNA marks—hypermethylations—which are thought to enhance tumor survival by silencing growth-restraining and DNA-repair genes.

The study included 20 evaluable PTCL patients, 17 of whom had the TFH subtype based on genetic tests of their tumors. All but one had advanced PTCLs of stages III-IV. Three-quarters (15/20) of the patients showed complete responses, and all were PTCL-TFH patients—implying a complete-response rate of 88.2% for this subgroup. Although there was no placebo or standard-treatment comparison group, end-of-treatment complete response rates for PTCL patients treated with standard chemotherapy-only, such as CHOP-based regimens, are usually in the 30-40% range, said Dr. Ruan.

The median follow-up time for the patients was 21 months, allowing researchers to estimate two-year progression-free survival rates of 65.8% for all 20 patients, and 69.2% for the 17 PTCL-TFH patients. Side-effects were comparable to what is normally seen in standard chemotherapy treatment.

[ConservativeMind]

88.2% cure rate adding azaciditine (Vidaza) to the standard therapy.

It’s available today.

[ConservativeMind]

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[bigfootbob]

Those are impressive numbers. A lot of hope, right there.