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BackgroundPeripheral T-cell lymphoma (PTCL) is featured with a poor survival outcome. China has approved chidamide, an oral novel histone deacetylase inhibitor, for patients diagnosed with relapsed or refractory PTCL.ObjectiveWe compared the benefit of traditional chemotherapy alone and a combination of chidamide and traditional chemotherapy against newly diagnosed PTCL. Prognostic factors related to progression and survival in patients diagnosed with untreated PTCL were also investigated.Methods104 patients with newly diagnosed PTCL were enrolled and divided into chemotherapy (ChT) group and chemotherapy combined with chidamide (ChT+C) group. Survival curves were plotted by the Kaplan-Meier method. Univariate and multivariate analysis were conducted with Log-rank test and Cox’s proportional hazard regression. Subgroup analysis and interaction tests were conducted to evaluate factors associated with prognostic differences between ChT and ChT+C groups.ResultsCompared with patients in ChT group, those in ChT+C group had superior progression-free survival (PFS) (p=0.047). However, there was no significantly statistical difference observed between the two groups in overall survival (OS) (p=0.212). High IPI scores have a negative relationship with survival. Multivariate analysis revealed that the type of frontline treatment regimen is an independent factor associated with PFS of PTCL patients (p=0.045). In the subgroup of patients with high international prognostic index scores (3-5), the HR value for PFS comparing ChT with ChT+C was 4.675. A test of interaction between IPI and treatment showed statistical significance (p = 0.037), implying that the benefits of ChT+C are higher for patients with high IPI scores.ConclusionsIn summary, the combination of ChT and chidamide may provide a promising prospect for patients with newly diagnosed PTCL.

e18020 Background: The prognosis of patients (pts) with recurrent or metastatic nasopharyngeal carcinoma (R/M NPC) is poor, especially for those who had failed two or more lines of prior systemic therapy. Anlotinib is a novel tyrosine kinase inhibitor that can inhibit tumor angiogenesis and proliferation by targeting VEGFR, FGFR, PDGFR, and c-Kit. A prospective, single-arm, phase 2 trial (NCT03906058) was performed to assess the efficacy and safety of single-agent anlotinib against R/M NPC and here we report the final results of this study. Methods: Eligible pts were aged 18-70 years old, diagnosed with histologically confirmed R/M NPC, had at least one measurable lesion and failed at least two lines of prior systemic treatments including chemotherapy, targeted therapy, or immunotherapy. Anlotinib was administered at 12 mg QD orally from day 1 to day 14 every 3 weeks until disease progression or intolerable toxicity. The primary endpoint was confirmed disease control rate (DCR). The second endpoints included confirmed objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and safety. Tumor response was assessed according to RECIST 1.1 and adverse events were assessed according to NCI-CTCAE v5.0. Results: From April 2019 to March 2021, 39 pts were enrolled. 33 were male and 6 were female. The median age was 46.7 years (range, 20-64). 24 pts (61.5%) had liver metastasis. 29 pts (74.4%) had previously received 2 lines of systemic treatments and others received 3 or more. 19 pts (48.7%) pts had been exposed to anti-PD-1 immunotherapy. The median treatment duration of anlotinib was 4 cycles (range, 0.5-20). At the data cutoff date of Feb.1st 2022, 36 pts have underwent tumor response evaluation and the best response to anlotinib was partial response for 8 pts and stable disease for 20 pts. The DCR was 77.8% and ORR was 22.2%. 28 patients have progressed. For the intent-to-treat population, the median PFS was 5.7 months (95% CI: 4.7-6.7). 21 pts have died and the median OS was 23.9 months (95% CI: 5.3-42.5). The most common treatment-related adverse event (TRAE) of any grade was hand-foot syndrome (HFS) (24 pts). Grade 3 TRAEs included HFS (9 pts), mucositis (7 pts), hypertension (21 pts), liver dysfunction (2 pts) and pneumonia (1 pts). Only one grade 4 TRAE (mucositis) was reported and no treatment-related death was observed. 13 pts experienced hemorrhage, all were grade 1 or 2. Conclusions: Anlotinib monotherapy seemed to be a promising option for pts with R/M NPC who were heavily treated. The survival benefits were impressive and the toxicity was tolerable. Clinical trial information: NCT03906058.

Background Nurses’ palliative and hospice care-specific education is associated with the quality of palliative and hospice care that influences health outcomes of patients with life-limiting illnesses and their caregivers. However, China lacks measures available to assess nurses’ educational needs in palliative and hospice care. The End-of-Life Professional Caregiver Survey (EPCS) is a psychometrically reliable self-reporting scale to measure multidisciplinary professionals’ palliative and hospice care educational needs. This study was performed to explore the psychometric properties of the Chinese version of the EPCS (EPCS-C) among Chinese nurses. Methods We translated and culturally adapted the EPCS into Chinese based on Beaton and colleagues’ instrument adaptation process. A cross-sectional study design was used. We recruited 312 nurses from 1482 nurses in a tertiary hospital in central China using convenience sampling to complete the study. Participants completed the EPCS-C and a demographic questionnaire. Exploratory and confirmatory factor analysis was carried out to test and verify the construct validity of the nurse-specific EPCS-C. Cronbach’s alpha coefficient was used to appraise the reliability of the nurse-specific EPCS-C. Results A three-factor structure of EPCS-C was determined, including cultural, ethical, and national values; patient- and family-centered communication; and effective care delivery. The exploratory factor analysis explained 70.82% of the total variances. The 3-factor solution of the nurse-specific EPCS-C had a satisfactory model fit: χ2 = 537.96, χ2/df = 2.96, CFI = 0.94, RMSEA = 0.079, IFI = 0.94, and GFI = 0.86. Cronbach’s alpha coefficient of the overall questionnaire was 0.96. Conclusions The nurse-specific EPCS-C showed satisfactory reliability and validity to assess nurses’ palliative and hospice care educational need. Further research is required to verify the reliability and validity of the EPCS-C in a larger sample, especially the criterion-related validity.

Adult T-cell lymphoblastic lymphoma (T-LBL) is a rare and aggressive subtype of non-Hodgkin’s lymphoma that differs from pediatric T-LBL and has a worse prognosis. Due to its rarity, little is known about the genetic and molecular characteristics, optimal treatment modalities, and prognostic factors of adult T-LBL. Therefore, we summarized the existing studies to comprehensively discuss the above issues in this review. Genetic mutations of NOTCH1/FBXW7 , PTEN , RAS , and KMT2D , together with abnormal activation of signaling pathways, such as the JAK-STAT signaling pathway were described. We also discussed the therapeutic modalities. Once diagnosed, adult T-LBL patients should receive intensive or pediatric acute lymphoblastic leukemia regimen and central nervous system prophylaxis as soon as possible, and cranial radiation-free protocols are appropriate. Mediastinal radiotherapy improves clinical outcomes, but adverse events are of concern. Hematopoietic stem cell transplantation may be considered for adult T-LBL patients with high-risk factors or those with relapsed/refractory disease. Besides, several novel prognostic models have been constructed, such as the 5-miRNAs-based classifier, 11-gene-based classifier, and 4-CpG-based classifier, which have presented significant prognostic value in adult T-LBL.

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