Dr. Mehta-Shah on the Variations of the CHOP Regimen in PTCL

Neha Mehta-Shah, MD, MSCI, associate professor, Department of Medicine, Oncology Division, Medical Oncology, Washington University School of Medicine in St. Louis, and medical oncologist, Siteman Cancer Center, discusses variations of CHOP-based chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone) in peripheral T-cell lymphoma (PTCL).

Although the CHOP regimen has remained a standard treatment in many lymphomas, deviations from or additions to this standard are important to consider for some patients, Mehta-Shah says. One common CHOP-based regimen is CHOEP, which adds etoposide chemotherapy for 3 days with each cycle of CHOP, Mehta-Shah notes.

Another option is brentuximab vedotin (Adcetris) plus CHP, known as BV-CHP, which has demonstrated improved progression-free survival and overall survival (OS) in patients with anaplastic large cell lymphoma, a disease which expresses the protein CD30, the target of brentuximab vedotin, Mehta-Shah explains. However, BV-CHP is still an effective approach in patients with other forms of lymphoma, such as PTCL not otherwise specified (NOS) or angioimmunoblastic T-cell lymphoma, Mehta-Shah says.

For instance, the phase 3 ECHELON-2 study (NCT01777152), which compared BV-CHP with CHOP alone, included patients who did not have anaplastic large cell lymphoma. This study demonstrated an OS benefit with BV-CHP in these patients, with a 5-year OS rate of 46.2% in patients with PTCL NOS vs 35.9% with CHOP alone, Mehta-Shah concludes.