First-line immunochemotherapy for extranodal natural killer/T cell lymphoma

We congratulate Xiao-Peng Tian and colleagues 1 Tian XP Cai J Xia Y et al. First-line sintilimab with pegaspargase, gemcitabine, and oxaliplatin in advanced extranodal natural killer/T cell lymphoma (SPIRIT): a multicentre, single-arm, phase 2 trial. Lancet Haematol. 2024; (published online March 27. https://doi.org/10.1016/S2352-3026(24)00066-8.) Google Scholar for their Article in The Lancet Haematology, on the achievement of the promising result of their trial investigating first-line immunochemotherapy for advanced-stage extranodal NK/T-cell lymphoma (ENKTL). With the advantage of asparaginase-based regimens and standardised radiotherapy, the outcome of ENKTL has been substantially improved during the past decade, 2 Qi SN Yang Y Song YQ et al. First-line non-anthracycline-based chemotherapy for extranodal nasal-type NK/T-cell lymphoma: a retrospective analysis from the CLCG. Blood Adv. 2020; 4: 3141-3153 Crossref PubMed Scopus (35) Google Scholar particularly in early-stage disease (5-year overall survival 55–90%). 3 Qi SN Yang Y Zhang YJ et al. Risk-based, response-adapted therapy for early-stage extranodal nasal-type NK/T-cell lymphoma in the modern chemotherapy era: a China Lymphoma Collaborative Group (CLCG) study. Am J Hematol. 2020; 95: 1047-1056 Crossref PubMed Scopus (0) Google Scholar However, the prognosis of patients with advanced-stage disease is still extremely poor with 5-year overall survival of 30–40% presenting the best effectiveness for current cytotoxic regimens. In the SPIRIT study, 1 Tian XP Cai J Xia Y et al. First-line sintilimab with pegaspargase, gemcitabine, and oxaliplatin in advanced extranodal natural killer/T cell lymphoma (SPIRIT): a multicentre, single-arm, phase 2 trial. Lancet Haematol. 2024; (published online March 27. https://doi.org/10.1016/S2352-3026(24)00066-8.) Google Scholar sintilimab and P-GMOX (pegaspargase, gemcitabine, and oxaliplatin) showed favourable outcomes with manageable toxicities in advanced-stage ENKTL, with a complete response rate of 85% (95% CI 70–94) and 2-year progression-free survival (PFS) of 64% (48–86). First-line sintilimab with pegaspargase, gemcitabine, and oxaliplatin in advanced extranodal natural killer/T cell lymphoma (SPIRIT): a multicentre, single-arm, phase 2 trialCombination of sintilimab with P-GEMOX seems to be an active and safe first-line regimen for patients with advanced ENKTL. Full-Text PDF