Efficacy and safety of induction therapy with first-line chidamide plus chemotherapy and sequential chidamide maintenance therapy for peripheral T-cell lymphoma
10.3760/cma.j.cn115355-20240808-00124
- VernacularTitle:西达本胺一线联合化疗诱导治疗序贯单药维持治疗外周T细胞淋巴瘤效果和安全性
- Author:
Donglu ZHAO
1
;
Ou BAI
;
Jun MA
Author Information
1. 哈尔滨血液病肿瘤研究所血液科，哈尔滨 150010
- Keywords:
Lymphoma, T-cell, peripheral;
Chidamide;
Drug therapy;
Treatment outcome;
Adverse reactions;
Meta-analysis
- From:
Journal of Leukemia & Lymphoma
2025;34(4):222-229
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of induction therapy with first-line chidamide plus chemotherapy and sequential chidamide maintenance therapy for peripheral T-cell lymphoma (PTCL) to provide evidence for clinical medication.Methods:The relevant literature in the databases of Cochrane Library, PubMed, EMbase, Web of Science, Chinese Biomedical Database, China National Knowledge Infrastructure Database, Wanfang, and VIP from December 2014 to November 2023 were retrieved. Meta-analysis and comparison were conducted on the objective response rate (ORR), complete remission (CR) rate, progression-free survival (PFS), and overall survival (OS) of patients receiving induction therapy with first-line chidamide plus chemotherapy and sequential chidamide maintenance therapy (chidamide combined with chemotherapy group) and those receiving chemotherapy alone (control group). A systematic descriptive analysis was performed on the occurrence of adverse events.Results:A total of 5 relevant literature on the induction therapy with first-line chidamide plus CHOP/CHOP-like regimens and sequential chidamide maintenance therapy for PTCL was included, including 350 initial-treated PTCL patients. Among them, there were 176 cases in the chidamide combined with chemotherapy group and 174 cases in the control group. The CR rate of the chidamide combined with chemotherapy group was higher than that of the control group [59.6% (90/151) (95% CI: 51.9%-67.5%) vs. 41.6% (62/149) (95% CI: 27.8%-51.7%)], and the difference was statistically significant ( P < 0.01); the ORR of the chidamide combined with chemotherapy group was 83.4% (126/151) (95% CI: 73.3%-94.1%), while the control group was 69.1% (103/149) (95% CI: 58.4%-79.2%), and the difference was not statistically significant ( P = 0.051). The 2-year PFS rate of the chidamide combined with chemotherapy group was higher than that of the control group [60.2% (106/176) (95% CI: 47.1%-74.6%) vs. 31.6% (55/174) (95% CI: 17.8%-45.7%)], and the difference was statistically significant ( P < 0.01); the 2-year OS rate of the chidamide combined with chemotherapy group was higher than that of the control group [83.2% (114/137) (95% CI: 66.8%-100.0%) vs. 53.4% (93/174) (95% CI: 42.1%-67.9%)], and the difference was statistically significant ( P < 0.01). There was no statistically significant difference between the chidamide combined with chemotherapy group and the control group in the incidence of grade 3-4 neutropenia [60.6% (20/33) and 57.6% (19/33)], anemia [17.9% (20/112) and 16.0% (17/106)] and thrombocytopenia [22.3% (25/112) and 22.6% (24/106)] (all P > 0.05); during the maintenance therapy with chidamide, the incidence of grade 3-4 neutropenia, anemia and thrombocytopenia was 28.1% (9/32), 12.5% (4/32) and 15.6% (5/32), respectively; the hematological adverse events mostly occured within 6 weeks of initial administration and were relieved after symptomatic treatment. Conclusions:Compared with only receiving chemotherapy, the first-line combination therapy with chidamide and CHOP/CHOP-like regimens can improve the CR rate of PTCL patients, and the maintenance therapy with chidamide alone after remission can improve PFS and OS and the hematological adverse reactions are tolerable.
