Project Details
Projekt
Allogeneic Cell Therapy in Refractory T-Cell Lymphoma (REACT).
Subject Area
Hematology, Oncology
Term
since 2026
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 541369058
Peripheral T-cell lymphoma (PTCL) is a rare disease that consists of various subtypes. With few exceptions, the prognosis is poor with a 2-year progression-free survival (PFS) rate of 27-40%. The standard first-line treatment is chemotherapy according to the CHO(E)P, or for a specific subtype, the BV-CHP protocol. Attempts to improve the results with other therapies have failed. The attempt to consolidate treatment success through high-dose chemotherapy with autologous blood stem cell transplantation (autoSCT) is controversial. Primary refractory disease is a particular feature of PTCL. Despite responding to the first treatment cycles, around one third of patients experience disease progression with continued treatment. Of those patients who do not experience disease progression, many do not achieve complete remission at the end of treatment. As the chemotherapies then used have only limited efficacy, most primary refractory patients never achieve remission and succumb to their disease. Patients who relapse after a prolonged period of disease control have better prospects, as allogeneic transplantation (alloSCT), the most effective treatment method, achieves a cure in about half of transplanted patients. The biggest barrier preventing patients with primary refractory disease from undergoing alloSCT is disease progression, so these patients should be identified before this event occurs. Chemotherapy protocols used for lymphoma treatment prior to transplantation are often ineffective and have significant toxicity. This further reduces the number of patients who can receive an allogeneic transplant. In the PTCL subgroup of a large multicenter lymphoma trial (PETAL), positron emission tomography/computed tomography (PET/CT) identified PTCL patients with treatment failure before lymphoma growth during ongoing therapy or relapse. Therefore, PET/CT could open up the possibility of alloSCT for a significant proportion of patients with a devastating prognosis. The novelty of the REACT trial design lies not in the treatment regimens, but in the use of PET/CT during the treatment phase for early detection of treatment failure and initiation of alloSCT. PET/CT-defined treatment failure may allow affected patients to undergo alloSCT in good condition and with low tumor burden. If the hypothesis is confirmed, the study will improve the survival of high-risk PTCL patients. A therapy adapted to the PET/CT response could become the standard treatment for these patients
DFG Programme
Clinical Trials
