PD-1 Inhibitors Improve Survival in First-Line NK/T-Cell Lymphoma Treatment

Extranodal natural killer/T-cell lymphoma (ENKTL) remains a highly aggressive malignancy, frequently associated with Epstein-Barr virus infection and a high risk of early treatment failure [1, 2]. While localized disease often responds to combined modality therapy, patients with advanced or high-risk presentations face a dismal prognosis, as traditional anthracycline-based regimens are largely ineffective due to high P-glycoprotein expression [1, 2]. The introduction of asparaginase-based chemotherapy has improved response rates, yet many patients still experience rapid progression or relapse [3, 4]. Recent clinical focus has shifted toward the programmed cell death 1 (PD-1) pathway, given that these tumors often overexpress PD-L1 as a mechanism of immune evasion [2, 5]. Although PD-1 inhibitors (PD1i) have demonstrated efficacy in the relapsed or refractory setting, their utility as an initial intervention has remained an open clinical question [6, 5]. A retrospective multicenter analysis now provides concrete survival data regarding the integration of these immunotherapies into first-line protocols.