First-line treatment of primary ovarian lymphoma in anaplastic lymphoma kinase-positive anaplastic large-cell lymphoma

Clinical scenario

This protocol addresses first-line management of primary ovarian lymphoma when the confirmed histological subtype is anaplastic lymphoma kinase-positive anaplastic large-cell lymphoma (ALK-positive ALCL). The treatment approach is specific to this subtype and is determined at the outset of first-line therapy.

Treatment approach

Management is risk- and stage-stratified. Chemotherapy is the central modality, with consolidative radiotherapy incorporated in selected patient groups depending on disease stage and risk profile.

The complete regimen, including specific agent selection, sequencing criteria, and eligibility thresholds, is available in the full protocol below.

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References

DOI: 10.1016/j.annonc.2025.07.014

First-line treatment of ALK-positive ALCL:

In patients with limited-stage, non-bulky disease and a favourable pre-therapeutic risk profile, abbreviated ChT (e.g. three to four cycles of BV-CHP or CHOEP) [III, B] followed by consolidative ISRT (e.g. 30-40 Gy) in responding patients [IV, B] can be recommended.

All other ChT-eligible patients should be offered six cycles of BV-CHP [I, A].

Six cycles of CHO(E)P is an alternative for patients with stage I-II high-risk (bulky disease, IPI ≥2 or age >40 years) or advanced-stage disease [III, B].

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