Peripheral T‐Cell Lymphoma: What's Next?

ABSTRACT Peripheral T‐cell lymphoma (PTCL) is a rare and heterogeneous group of diseases, with over 30 subtypes according to the International Consensus Classification of Mature Lymphoid Neoplasms (ICC) and World Health Organization Classification of Hematolymphoid Tumors (WHO‐HEM) 2022. The classification complexity reflects the underlying genetic and biological diversity of PTCL. For decades, distinct PTCL subtypes have been uniformly treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or CHOP‐like regimens originally developed for mainly B‐cell lymphoma. Attempts to improve frontline CHOP‐plus strategies have failed mainly due to toxicities and lack of biological rationale. Only the ECHELON‐2 trial succeeded as more than 70% of patients had anaplastic large cell lymphoma (ALCL), where brentuximab vedotin (BV) is most effective. Looking ahead to 2025 and beyond, future treatment strategies for PTCL should be guided by a deeper understanding of its underlying biology rather than relying on empirical extrapolations from other lymphomas.