TCL-386: Patterns of Care for Elderly Patients with Peripheral T-Cell Lymphoma: A Report from the International T-Cell Project 1.0

Context Scarce data on clinical features and treatment outcomes of elderly patients is presented in clinical practice. The outcomes of elderly patients are worse, especially with aggressive lymphoma types. The conventional CHOP-based chemotherapy is a standard frontline treatment for peripheral T-cell lymphomas (PTCLs). Objective In this report, we aimed to compare outcomes in elderly patients with PTCLs in the global International T-Cell Project (TCP) after treatment with combination chemotherapy, reduced doses, or palliative single-agent approaches. The primary and secondary endpoints were 5-year OS and PFS. Patients or Other Participants We performed a sub-analysis of 246 patients >70 years with PTCLs out of 1,553 cases enrolled between 2006 and 2018 in the TCP, involving 74 institutions in 13 countries in Europe, North/South America, and Asia. All patients received frontline therapy for anaplastic large cell lymphoma (ALCL) ALK–, ALCL ALK +, angioimmunoblastic T-cell lymphoma (AITL), and PTCL not otherwise specified (NOS). Baseline patient characteristics were summarized with descriptive statistics. Survival analyses were performed using Kaplan–Meier method. The TCP is registered on ClinicalTrials.gov (NCT01142674). Results Of 246 patients ≥70 years, 217 (88%) patients received frontline therapy with curative intent, and 29 (12%) patients with palliative intent. The median age at diagnosis was 76 years (range 70–89) in the curative intent arm and 77 years (range 70–85) in the palliative arm. Stage III-IV had 77.4% of patients, and 54% were males. High IPI and PIT scores were found in 62% and 65% of patients, respectively. Median OS of curative vs palliative intent was 59 vs 4.7 months (p=0.001). The 3- and 5-year OS for patients with curative treatment arm were 71% and 50%, vs 28% and 22% with palliative treatment, respectively. Median PFS of curative vs palliative intent patients was 37 vs 3.7 months (p=0.004). The 3- and 5-year PFS rates for patients with curative and palliative approaches were 54% and 37% vs 21% and 16%, respectively. Conclusions In this prospective registry cohort of patients 70 years and older, we observed improved survival for patients treated with curative combination therapy compared to palliative single agents. Based on our findings, the inclusion of otherwise fit older patients in ongoing clinical trials of frontline therapies incorporating targeted agents is warranted.