The following is a summary of “Efficacy of Frontline Chemotherapy for Extranodal Natural Killer/T-Cell Lymphoma: A Systematic Review and Network Meta-Analysis,” published in the October 2023 issue of Hematology by Luo et al.
Non-anthracycline (ANT)-based chemotherapy has improved survival in extranodal natural killer/T-cell lymphoma (ENKTCL), but the best drug combinations remain debated. Researchers started a retrospective study to identify the most effective chemotherapy regimens for newly diagnosed ENKTCL.
They conducted a network meta-analysis to assess survival and treatment response variations among different regimens. The main focus was on overall survival (OS), while secondary outcomes encompassed progression-free survival (PFS), objective response rate (ORR), and complete response (CR). A Bayesian framework was employed for the network meta-analysis. Rank probabilities were evaluated using the surface under the cumulative ranking curve (SUCRA). Inconsistency was assessed using the node-splitting method.
The results showed 1,113 patients across 10 studies. Chemotherapy regimens were categorized into 5 modalities, enabling 5 direct comparisons. Asparaginase (ASP)/gemcitabine (GEM) regimens were found superior in OS compared to ANT-based, non-ASP/ANT-based, and ASP/methotrexate (MTX) regimens. While no notable differences were observed compared to ASP/not otherwise specified-based, ASP/GEM regimens remained the optimal choice for chemotherapy in OS. Additionally, ASP/GEM regimens displayed benefits in PFS, ORR, and CR.
Investigators concluded that ASP/GEM-based regimens may be the most effective first-line chemotherapy option for ENKTCL.