title: Highly Diverse Efficacy of Salvage Treatment Regimens for Relapsed or Refractory Peripheral T-Cell Lymphoma: A Systematic Review.
abstract: BACKGROUND
  The goal of this study was to perform a systematic review to examine the efficacy and safety of various salvage therapy regimens on patients with relapsed/refractory PTCL.
  
  
  METHODS
  The electronic searches were performed using PubMed, Cochrane Library, EMBASE, and Web of Science from inception through June 2015, with search terms related to relapsed/refractory PTCL, salvage chemotherapy regimens, and clinical trials. An eligible study met the following inclusion criteria: (1) Patients had refractory or relapsed PTCL; (2) drug regimens were used for salvage therapy; (3) the study was a clinical trial; (4) the study reported on a series of at least 10 patients of PTCL.
  
  
  RESULTS
  Of 35 records identified, a total of 14 studies were eligible for systematic reviews, and 12 different salvage regimens were investigated. A total of 618 relapsed/refractory PTCL patients were identified. The ORRs ranged from 22% for those treated with lenalidomide to 86% for those with brentuximab vedotin. By the three most frequent subtypes, the ORRs ranged from 14.2% to 71.5% for patients with the PTCL-NOS subtype, 8% to 54% for AITL subtypes, and 24% to 86% for the ALCL subtype. The medians of DOR, PFS, and OS ranged from 2.5 to 16.6 months, 2.6 to 13.3 months, and 3.6 to 14.5 months, respectively. The most frequently reported grade 3 or 4 adverse events (AEs) were hematological AEs, such as neutropenia and thrombocytopenia.
  
  
  CONCLUSIONS
  The efficacy of salvage therapy regimens is highly diverse for patients with relapsed/refractory PTCL; this heterogeneity in therapeutic effects might be due to the diversity in mechanisms, PTCL subtype distribution, and/or numbers/profiles of prior therapy. Comparative studies with matched pair analysis are warranted for more evidence of the salvage treatment effect on relapsed or heavily pretreated patients with PTCL.
authors.affiliation: Institute of Health Policy and Management, National Taiwan University, 17 Xu-Zhou Rd., Taipei, 100, Taiwan.|Golden Dream Think Tank and Research Center, 17 Songjiang Rd., Taipei, 104, Taiwan.|School of Health Care Administration, Taipei Medical University, 250 Wuxing Street, Taipei, Taiwan.
authors.forename: Ya-Ting
authors.initials: YT
authors.lastname: Yang
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, 252 Wuxing Street, Taipei, 110, Taiwan.|Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei, 110, Taiwan.
authors.forename: Cheng-Jeng
authors.initials: CJ
authors.lastname: Tai
authors.affiliation: Center for Evidence-Based Medicine, Taipei Medical University, 250 Wuxing Street, Taipei, 110, Taiwan.|Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei, 110, Taiwan.|Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, NO.111, Section 3, Hsing-Long Rd, Taipei, 116, Taiwan.|Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, NO.111, Section 3, Hsing-Long Rd, Taipei, 116, Taiwan.
authors.forename: Chiehfeng
authors.initials: C
authors.lastname: Chen
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, 252 Wuxing Street, Taipei, 110, Taiwan.
authors.forename: Hong-Cheng
authors.initials: HC
authors.lastname: Wu
authors.affiliation: Nevron, International Medical Center, Vladivostok, Russia.
authors.forename: Natalia
authors.initials: N
authors.lastname: Mikhaylichenko
authors.affiliation: Golden Dream Think Tank and Research Center, 17 Songjiang Rd., Taipei, 104, Taiwan.|Department of Public Health, China Medical University, 91 Hsueh-Shih Road, Taichung, 404, Taiwan.
authors.forename: Hsien-Tsai
authors.initials: HT
authors.lastname: Chiu
authors.affiliation: Institute of Health Policy and Management, National Taiwan University, 17 Xu-Zhou Rd., Taipei, 100, Taiwan.|Golden Dream Think Tank and Research Center, 17 Songjiang Rd., Taipei, 104, Taiwan.
authors.forename: Yun-Yi
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Golden Dream Think Tank and Research Center, 17 Songjiang Rd., Taipei, 104, Taiwan.|School of Health Care Administration, Taipei Medical University, 250 Wuxing Street, Taipei, Taiwan.
authors.forename: Yi-Hsin Elsa
authors.initials: YE
authors.lastname: Hsu
mesh_terms: D018572:Disease-Free Survival; D006801:Humans; D016411:Lymphoma, T-Cell, Peripheral / Q000628:therapy*; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome