Phase II trial of denileukin diftitox for relapsed/refractory T‐cell non‐Hodgkin lymphoma

This phase II study evaluated the safety and efficacy of denileukin diftitox, an interleukin‐2–diphtheria toxin fusion protein, in relapsed/refractory T‐cell non‐Hodgkin lymphoma (T‐NHL), excluding cutaneous T‐cell lymphoma. Eligible patients received denileukin diftitox 18 μg/kg/d × 5 d every 3 weeks for up to eight cycles. Tumour staging was performed every two cycles and the primary endpoint was the objective response rate [complete response (CR) + partial response (PR)]. For 27 patients enrolled, median age: 55 years (range 26–80 years), 70·4% male, and mean prior therapies: 2·5 (range 1–6). Objective responses (six CRs, seven PRs) were achieved in 13 patients (48·1%), stable disease in eight (29·6%) and six (22·2%) had progressive disease. An objective response was achieved in eight of 13 patients (61·5%) with CD25+ tumours (four CR/four PR) and five of 11 patients (45·5%) with CD25− tumours (two CR/three PR). Median progression‐free survival was 6 months (range, 1–38+ months). Most adverse reactions were grade 1/2 and transient. No grade 4–5 toxicities were reported. Denileukin diftitox had significant activity and was well tolerated in relapsed/refractory T‐NHL, with responses observed in both CD25+ and CD25− tumours. Further studies of denileukin diftitox in combination with other agents are warranted in previously untreated and relapsed/refractory T‐NHL.