Epigenetic-Targeting Regimens vs. Conventional Chemotherapy in Relapsed/Refractory PTCL: A Meta-Analysis

PurposeRelapsed/refractory peripheral T-cell lymphoma (R/R PTCL) lacks a uniform salvage standard and outcomes with conventional chemotherapy (CC) remain suboptimal.This meta-analysis compared epigenetic-containing regimens (Epi-Rx) and CC in R/R PTCL. Materials and MethodsWe searched MEDLINE, Embase, and the Cochrane Library through May 2025 for prospective or retrospective studies evaluating Epi-Rx (≥1 HDAC, DNMT/hypomethylating, or EZH1/2 inhibitor, alone or in combination) or CC without epigenetic agents.Random-effects models pooled single-arm proportions, with prespecified subgroup analyses and meta-regression. ResultsThirty-eight studies (2,170 patients; 24 Epi-Rx cohorts and 16 CC cohorts) were included.Pooled overall response rate (ORR) was comparable between Epi-Rx and CC (46% [95% CI, 40%-52%] vs. 47% [95% CI, 41%-54%]; p=0.77), whereas 1-year progression-free survival (PFS) rate favored Epi-Rx (28% [95% CI, 24%-32%] vs 20% [95% CI, 16%-23%]; p