In a conversation with CancerNetwork®, Viviana Cortiana, MS4, medical student in the Department of Medical and Surgical Sciences at the University of Bologna, and Yan Leyfman, MD, a resident physician from the Icahn School of Medicine of the Mount Sinai Health System, discussed their publication in the March 2025 issue of ONCOLOGY titled “Expanding horizons in T-cell lymphoma therapy: a focus on personalized treatment strategies.” Throughout the discussion, the authors spoke about the current lymphoma landscape, CAR T-cell therapy, and the evolving understanding of the tumor microenvironment.

Specifically, Cortiana covered a shift from histology-based classification to molecular tumor type classification using next-generation sequencing, as well as a growing interest in biomarker-driven therapies. Regarding the limited efficacy of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in T-cell lymphoma, she listed potential advances in combination therapies for angioimmunoblastic T-cell lymphoma (AITL), which include combining P13K and HDAC inhibition as well as CD30- and TRBC1-targeting CAR T-cell therapies.

Furthermore, Leyfman discussed strategies that “reprogram” the microenvironment to address malignant T cells, particularly through epigenetic and adoptive cell therapies. Leyfman concluded by discussing future implications for T-cell lymphoma treatment, emphasizing an emergence of precision medicines and armored CAR engineering strategies.

Authors of the manuscript published in ONCOLOGY outlined the available treatment options for peripheral T-cell lymphoma (PTCL), which include targeted therapies through EZH2 inhibition, chemotherapy with CHOP, CAR T-cell therapies, and allogenic stem cell transplantation. Additionally, they highlighted encouraging results from clinical trials evaluating epigenetic-targeted therapies through the identification of molecular aberrations, which can help tailor treatments to individual patients. 

Furthermore, the article explored limitations of chemotherapy as well as autologous stem cell transplantation (ASCT), which may not be feasible for older patients or those with comorbidities. Authors suggested that targeted therapies may enhance tumor specificity while reducing systemic toxicity. Given the risks associated with ASCT, they emphaisized a focus on the incorporation of optimized treatment strategies, such as novel pharmaceuticals and combination therapies, into clinical practice for patients with PTCL.