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This combination regimen consists of the anti-PD-1 monoclonal antibody sintilimab, the immunomodulatory agent lenalidomide, and the hypomethylating agent azacitidine. It is being developed by investigators at The First Affiliated Hospital of Soochow University as a salvage therapy for relapsed or refractory peripheral T-cell lymphoma (R/R PTCL). Sintilimab functions as a checkpoint inhibitor by targeting the PD-1 receptor to restore T-cell mediated anti-tumor immunity. Lenalidomide provides synergistic immunomodulation and direct tumoricidal effects, while azacitidine acts as a DNA methyltransferase inhibitor that may sensitize T-cell lymphomas to immunotherapy by reversing epigenetic silencing of tumor antigens. A Phase II trial (NCT05182957) has demonstrated that this triplet combination is effective and has a manageable safety profile, with enhanced sensitivity observed in patients harboring mutations in RHOA, TET2, and DNMT3A.
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