Researchers from Italy have reported that Gemzar® (gemcitabine) is effective single-agent therapy for previously treated patients with peripheral T-cell lymphoma (PTCL) and mycosis fungoides (MF). The details of this study appeared in an early online publication in the Annals of Oncology on November 3, 2009.[1]

Peripheral T-cell lymphomas are a relatively uncommon form of NHL that generally do not respond as well to treatment as B-cell NHL. Though patients with B-cell NHL benefited significantly from Rituxan® (rituximab) therapy over the past decade, there is no comparable T-cell antibody for treatment of T-cell lymphomas. High-dose chemotherapy with autologous stem cell transplantation has been used with some success for the treatment of patients with T-cell lymphoma. However, even after autologous stem cell transplantation, the probability of recurrent disease is high. Allogeneic stem cell transplantation offers a more curative approach, but transplant-related mortality is high.  The optimal approach to the treatment of PTCL remains uncertain, and the prognosis for many patients is poor.

Gemzar has been incorporated into several salvage regimens for the treatment of B-cell non-Hodgkin’s lymphoma, but little is known about single-agent response in patients with T-cell lymphomas. The current study evaluated outcomes of 39 patients with PTCL or MF who had failed conventional therapies.  Nineteen patients in this study had MF and 20 PTCL. The overall response rate was 51%, with 23% having a complete response. The complete response rate for patients with MF was 16% compared with 30% for patients with PTCL. Seven of the patients with a complete response have maintained this status for 15-120 months. These authors concluded: “In our experience, gemcitabine proved to be effective in pretreated MF and PTCLU patients, even in the long term.”

Comments: These are impressive single-agent responses for patients with T-cell lymphoma. Another recent study of Gemzar in patients with cutaneous T-cell lymphoma found significant activity but with major complications from hematologic toxicities with usual dosing.[2] However, another study in patients with MF found good disease control with low-dose long-term Gemzar administration with little toxicity.[3]

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