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10 treatment settings, 10 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.
Brentuximab vedotin + CHP ×6 (ECHELON-2, OS benefit) ± consolidative autologous transplant.
The ADC that made the modern field credible (2011), for Hodgkin lymphoma and CD30+ lymphomas.
Autologous stem cell transplant collects the patient's own blood-forming stem cells, gives melphalan or another chemotherapy at a dose that would otherwise destroy the marrow, then returns the cells to rebuild it. It is standard consolidation in myeloma and for relapsed lymphoma, though CAR-T has displaced it in early-relapsing large B-cell lymphoma.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia · ECHELON-1, A+AVD arm | 91% | 82% |
| Febrile neutropenia · ECHELON-1, A+AVD arm | 19% | 19% |
| Peripheral sensory neuropathy · ECHELON-1, A+AVD arm | 65% | 10% |
| Vomiting · ECHELON-1, A+AVD arm | 33% | 3% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
CHOP or CHOEP (≤60 years) ×6, autologous transplant consolidation in responders; clinical trial preferred.
The red chemotherapy drug from a soil bacterium that is still the backbone of treatment for sarcoma, lymphoma and breast cancer, limited by cumulative heart damage.
Cyclophosphamide is an alkylating chemotherapy that damages DNA in dividing cells. It is part of CHOP for lymphoma, AC for breast cancer and VAC for childhood sarcomas, clears lymphocytes before CAR-T and prevents graft-versus-host disease after transplant; bladder bleeding, infertility and secondary leukaemia are its harms.
A plant-derived chemotherapy from the Madagascar periwinkle that has been in almost every childhood leukaemia and lymphoma regimen since the 1960s.
Autologous stem cell transplant collects the patient's own blood-forming stem cells, gives melphalan or another chemotherapy at a dose that would otherwise destroy the marrow, then returns the cells to rebuild it. It is standard consolidation in myeloma and for relapsed lymphoma, though CAR-T has displaced it in early-relapsing large B-cell lymphoma.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
Add these to your appointment list, or take the full question set for this cancer.
Pralatrexate, belinostat, romidepsin (ex-US), brentuximab (CD30+), gemcitabine-based regimens, allogeneic HSCT for fit responders.
Pralatrexate was the first drug approved specifically for relapsed peripheral T-cell lymphoma; about a third of patients respond.
Belinostat is an HDAC inhibitor for relapsed peripheral T-cell lymphoma; about a quarter of patients respond, and it can be used in patients with low platelets.
Romidepsin is an epigenetic drug for T-cell lymphomas of the skin and lymph nodes; its US lymph-node indication was withdrawn when a confirmatory trial failed.
The ADC that made the modern field credible (2011), for Hodgkin lymphoma and CD30+ lymphomas.
Allogeneic stem cell transplantation replaces a patient's blood system with a donor's after conditioning chemotherapy, so donor immune cells hunt down leukaemia left behind. It remains the only cure for adverse-risk acute myeloid leukaemia, high-risk acute lymphoblastic leukaemia and Richter transformation, at the price of graft-versus-host disease.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia · ECHELON-1, A+AVD arm | 91% | 82% |
| Febrile neutropenia · ECHELON-1, A+AVD arm | 19% | 19% |
| Peripheral sensory neuropathy · ECHELON-1, A+AVD arm | 65% | 10% |
| Vomiting · ECHELON-1, A+AVD arm | 33% | 3% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Skin-directed therapy (topical steroids, phototherapy, radiotherapy, total-skin electron beam), then mogamulizumab (MAVORIC), brentuximab (ALCANZA, CD30+), bexarotene, interferon, photopheresis; allogeneic HSCT for advanced disease.
Mogamulizumab is an antibody that clears cancerous T cells from the blood in mycosis fungoides and Sézary syndrome, the leukaemic form of skin lymphoma.
The ADC that made the modern field credible (2011), for Hodgkin lymphoma and CD30+ lymphomas.
Allogeneic stem cell transplantation replaces a patient's blood system with a donor's after conditioning chemotherapy, so donor immune cells hunt down leukaemia left behind. It remains the only cure for adverse-risk acute myeloid leukaemia, high-risk acute lymphoblastic leukaemia and Richter transformation, at the price of graft-versus-host disease.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia · ECHELON-1, A+AVD arm | 91% | 82% |
| Febrile neutropenia · ECHELON-1, A+AVD arm | 19% | 19% |
| Peripheral sensory neuropathy · ECHELON-1, A+AVD arm | 65% | 10% |
| Vomiting · ECHELON-1, A+AVD arm | 33% | 3% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Asparaginase-based chemotherapy (P-GemOx, SMILE) with involved-site radiotherapy for localised disease; PD-1 inhibitors at relapse.
Pembrolizumab is a PD-1 blocking antibody approved in more than 40 settings, from melanoma and lung cancer to the first tumour-agnostic approval for mismatch-repair-deficient tumours in 2017, and before and after surgery in triple-negative breast cancer. A subcutaneous form arrived in 2025, and it is the backbone partner for ADCs and personalised neoantigen vaccines.
IMRT and IGRT shape the radiation beam to the tumour's outline from multiple angles and check the patient's position with a scan before every session, so surrounding organs receive less dose. Fewer, larger doses are now standard in breast and prostate cancer, but a low-dose bath still spreads across normal tissue.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Hypothyroidism (immune-mediated) · Pooled monotherapy data, >2,800 patients | 8% | - |
| Pneumonitis (immune-mediated) · Pooled monotherapy data, >2,800 patients | 3.4% | - |
| Colitis (immune-mediated) · Pooled monotherapy data, >2,800 patients | 1.7% | - |
| Hepatitis (immune-mediated) · Pooled monotherapy data, >2,800 patients | 0.7% | - |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Four things to establish before treatment. Which entity: ALK-positive anaplastic large cell lymphoma does much better than every other nodal T-cell lymphoma and is curable with chemotherapy alone in most patients; ALK-negative anaplastic large cell lymphoma, angioimmunoblastic T-cell lymphoma, peripheral T-cell lymphoma not otherwise specified and the enteropathy-associated forms do considerably worse. CD30 expression by immunohistochemistry, because it decides whether brentuximab vedotin is added to first-line chemotherapy. Whether the disease is nodal, extranodal (nasal NK/T-cell), leukaemic (adult T-cell leukaemia/lymphoma, T-cell prolymphocytic leukaemia) or cutaneous, because those four groups have entirely different treatments. HTLV-1 serology where the patient comes from or has family from Japan, the Caribbean, west Africa, Iran or parts of South America, because adult T-cell leukaemia/lymphoma is treated differently from everything else. A breast implant-associated anaplastic large cell lymphoma presenting as a late seroma around an implant is treated primarily by complete surgical removal of the implant and capsule, and most patients need nothing else. That is a different disease from systemic anaplastic large cell lymphoma despite the shared name.
The ADC that made the modern field credible (2011), for Hodgkin lymphoma and CD30+ lymphomas.
FDG PET is the standard PET scan. A radioactive sugar shows which tissues are burning glucose fast, which most cancers do.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia · ECHELON-1, A+AVD arm | 91% | 82% |
| Febrile neutropenia · ECHELON-1, A+AVD arm | 19% | 19% |
| Peripheral sensory neuropathy · ECHELON-1, A+AVD arm | 65% | 10% |
| Vomiting · ECHELON-1, A+AVD arm | 33% | 3% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
ECHELON-2 randomised 452 patients with untreated CD30-positive peripheral T-cell lymphoma to brentuximab vedotin with cyclophosphamide, doxorubicin and prednisone (A+CHP) or to CHOP. Median progression-free survival by blinded independent review was 48.2 against 20.8 months (hazard ratio 0.71), with improved overall survival, and toxicity was comparable: febrile neutropenia 18 against 15 per cent and peripheral neuropathy 52 against 55 per cent. It is the only positive randomised first-line trial in this family in twenty years and it changed the standard. Three-quarters of the trial population had systemic anaplastic large cell lymphoma, so the benefit is best established there and is extrapolated to other CD30-positive entities. Six cycles are given, with G-CSF support. Vincristine is omitted because brentuximab vedotin is itself a tubulin-directed agent and giving both causes unacceptable neuropathy.
The ADC that made the modern field credible (2011), for Hodgkin lymphoma and CD30+ lymphomas.
Cyclophosphamide is an alkylating chemotherapy that damages DNA in dividing cells. It is part of CHOP for lymphoma, AC for breast cancer and VAC for childhood sarcomas, clears lymphocytes before CAR-T and prevents graft-versus-host disease after transplant; bladder bleeding, infertility and secondary leukaemia are its harms.
The red chemotherapy drug from a soil bacterium that is still the backbone of treatment for sarcoma, lymphoma and breast cancer, limited by cumulative heart damage.
Prednisone is the everyday steroid tablet in cancer care. It is the P in CHOP and MOPP for lymphoma, part of childhood leukaemia treatment, and taken with abiraterone in prostate cancer.
Injections of filgrastim or its long-acting form pegfilgrastim after chemotherapy make white cells recover faster, cutting the risk of life-threatening infections and allowing chemotherapy on schedule.
A+CHP improved progression-free and overall survival over CHOP in CD30-positive peripheral T-cell lymphoma; approved in November 2018.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia · ECHELON-1, A+AVD arm | 91% | 82% |
| Febrile neutropenia · ECHELON-1, A+AVD arm | 19% | 19% |
| Peripheral sensory neuropathy · ECHELON-1, A+AVD arm | 65% | 10% |
| Vomiting · ECHELON-1, A+AVD arm | 33% | 3% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
CHOP for six cycles is the default, and it is a default rather than a demonstrated best. No randomised trial has shown any regimen superior to CHOP in CD30-negative nodal peripheral T-cell lymphoma, and roughly half of patients are not cured by it. Adding etoposide (CHOEP) is standard in much of Europe for patients under 60 with a normal LDH, on the basis of a retrospective analysis of the German High-Grade Non-Hodgkin Lymphoma Study Group trials in which that subgroup had better event-free survival; the analysis was not randomised and not confined to T-cell lymphoma, so the practice rests on an observation rather than a trial. Adding romidepsin to CHOP was tested properly in the Ro-CHOP trial and failed, which is why the United States withdrew romidepsin's peripheral T-cell lymphoma indication. Angioimmunoblastic T-cell lymphoma is the entity in which the epigenetic drugs look most promising, because it is driven by mutations in TET2, DNMT3A, IDH2 and RHOA; azacitidine-containing combinations and histone deacetylase inhibitors are being tested and are not yet standard. Enteropathy-associated T-cell lymphoma is treated with intensive regimens and early nutritional support, because it presents with perforation or obstruction in a malnourished patient with coeliac disease. Entering a trial is a reasonable first choice rather than a last resort in this group.
Cyclophosphamide is an alkylating chemotherapy that damages DNA in dividing cells. It is part of CHOP for lymphoma, AC for breast cancer and VAC for childhood sarcomas, clears lymphocytes before CAR-T and prevents graft-versus-host disease after transplant; bladder bleeding, infertility and secondary leukaemia are its harms.
The red chemotherapy drug from a soil bacterium that is still the backbone of treatment for sarcoma, lymphoma and breast cancer, limited by cumulative heart damage.
A plant-derived chemotherapy from the Madagascar periwinkle that has been in almost every childhood leukaemia and lymphoma regimen since the 1960s.
Prednisone is the everyday steroid tablet in cancer care. It is the P in CHOP and MOPP for lymphoma, part of childhood leukaemia treatment, and taken with abiraterone in prostate cancer.
Etoposide is a chemotherapy from the mayapple plant, essential to curing testicular cancer (BEP), treating small-cell lung cancer, lymphomas, childhood sarcomas and leukaemias, and used in transplant conditioning.
Romidepsin is an epigenetic drug for T-cell lymphomas of the skin and lymph nodes; its US lymph-node indication was withdrawn when a confirmatory trial failed.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
Add these to your appointment list, or take the full question set for this cancer.
Consolidating a first complete or partial remission with high-dose therapy and an autologous stem cell transplant is standard practice in Europe and common in the United States for nodal peripheral T-cell lymphomas other than ALK-positive anaplastic large cell lymphoma, which does well enough without it. The evidence is a prospective single-arm Nordic study and a series of registry comparisons; there has never been a randomised trial, and the registry comparisons are subject to the obvious bias that only patients who respond well enough and stay fit enough reach transplant. So the row is written as it is: this is the convention, it is reasonable, and a patient is entitled to be told that its benefit has not been demonstrated against continuing observation. Stem cells are collected after two to four cycles, before the marrow is exhausted. Allogeneic transplant is reserved for relapsed disease and for hepatosplenic T-cell lymphoma, where it is the only treatment that produces long remissions.
Autologous stem cell transplant collects the patient's own blood-forming stem cells, gives melphalan or another chemotherapy at a dose that would otherwise destroy the marrow, then returns the cells to rebuild it. It is standard consolidation in myeloma and for relapsed lymphoma, though CAR-T has displaced it in early-relapsing large B-cell lymphoma.
Allogeneic stem cell transplantation replaces a patient's blood system with a donor's after conditioning chemotherapy, so donor immune cells hunt down leukaemia left behind. It remains the only cure for adverse-risk acute myeloid leukaemia, high-risk acute lymphoblastic leukaemia and Richter transformation, at the price of graft-versus-host disease.
Carmustine is a chemotherapy that reaches the brain. It is given by infusion for brain tumours, lymphoma and myeloma, and as a slow-release wafer left in the cavity after a brain tumour is removed.
Etoposide is a chemotherapy from the mayapple plant, essential to curing testicular cancer (BEP), treating small-cell lung cancer, lymphomas, childhood sarcomas and leukaemias, and used in transplant conditioning.
Cytarabine is the core chemotherapy for acute myeloid leukaemia, given with an anthracycline as the classic 7+3 induction and at high doses for consolidation; it is also injected into the spinal fluid to treat or prevent leukaemia in the brain.
The myeloma chemotherapy that is also the standard high-dose conditioning before autologous transplant, and, delivered directly into the liver's blood supply or the eye, treats uveal melanoma metastases and retinoblastoma.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
Add these to your appointment list, or take the full question set for this cancer.
Response rates to every available single agent sit between about 25 and 35 per cent, and remissions are usually short, so the question at relapse is whether the patient can be taken to an allogeneic transplant or a trial. Approved single agents in the United States: pralatrexate, an antifolate, approved in 2009 on a response rate of about 29 per cent; belinostat, a histone deacetylase inhibitor, approved in 2014 on about 26 per cent, usable when platelets are low; romidepsin, approved in 2011 and withdrawn from this indication after the confirmatory Ro-CHOP trial failed. Brentuximab vedotin is highly active in relapsed systemic anaplastic large cell lymphoma, where response rates are far higher than in other entities; its first-line United States approval with cyclophosphamide, doxorubicin and prednisone for untreated systemic anaplastic large cell lymphoma and other CD30-expressing peripheral T-cell lymphomas came on 16 November 2018. Availability differs sharply between countries: pralatrexate and belinostat are not routinely commissioned in England. Other options are gemcitabine-based chemotherapy (GemOx, GDP), which is widely used in the United Kingdom and has no randomised support, bendamustine, alemtuzumab in selected cases, and a clinical trial. Allogeneic transplant is the only treatment with curative potential at this point and is offered to fit patients who achieve a response. Valemetostat, an EZH1/EZH2 inhibitor, is approved in Japan for relapsed adult T-cell leukaemia/lymphoma and peripheral T-cell lymphoma and is in trials elsewhere; the corpus does not yet hold a record for it and this page does not quote a figure for it.
Pralatrexate was the first drug approved specifically for relapsed peripheral T-cell lymphoma; about a third of patients respond.
Belinostat is an HDAC inhibitor for relapsed peripheral T-cell lymphoma; about a quarter of patients respond, and it can be used in patients with low platelets.
Romidepsin is an epigenetic drug for T-cell lymphomas of the skin and lymph nodes; its US lymph-node indication was withdrawn when a confirmatory trial failed.
The ADC that made the modern field credible (2011), for Hodgkin lymphoma and CD30+ lymphomas.
A versatile chemotherapy used in pancreatic, bladder, lung, ovarian, breast and biliary cancers, in nasopharyngeal cancer, and as a bladder instillation.
The platinum drug that works in bowel cancer where cisplatin does not, the 'OX' in FOLFOX and CAPOX; its cost is nerve damage in hands and feet.
An East German chemotherapy rediscovered in the 2000s that became the backbone partner for rituximab in follicular, mantle cell and Waldenström lymphomas.
Alemtuzumab (Campath) is an antibody that wipes out lymphocytes carrying the CD52 marker. It is approved for chronic lymphocytic leukaemia and is supplied in the US through a restricted distribution programme.
Allogeneic stem cell transplantation replaces a patient's blood system with a donor's after conditioning chemotherapy, so donor immune cells hunt down leukaemia left behind. It remains the only cure for adverse-risk acute myeloid leukaemia, high-risk acute lymphoblastic leukaemia and Richter transformation, at the price of graft-versus-host disease.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia · ECHELON-1, A+AVD arm | 91% | 82% |
| Febrile neutropenia · ECHELON-1, A+AVD arm | 19% | 19% |
| Peripheral sensory neuropathy · ECHELON-1, A+AVD arm | 65% | 10% |
| Vomiting · ECHELON-1, A+AVD arm | 33% | 3% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.