A Retrospective Chart Review of Treatment Patterns and Overall Survival Among a Cohort of Patients with Relapsed/Refractory Mycosis Fungoides in France, Germany, Italy, Spain and the United Kingdom

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2023 Dec 9

PMID 38067371

Authors

Chalid Assaf

Timothy M Illidge

Nathalie Waser

Mary He

Tina Li

Athanasios Zomas

Nawal Bent-Ennakhil

Meredith Little

Pablo L Ortiz-Romero

Nicola Pimpinelli

Mehul Dalal

Martine Bagot

Affiliations

Soon will be listed here.

Abstract

(1) Background: Most patients with mycosis fungoides (MF), a form of cutaneous T-cell lymphoma (CTCL), develop relapsed/refractory (R/R) disease following front-line systemic therapy. This report describes treatment patterns and outcomes from the subpopulation with R/R MF. (2) Methods: This observational, retrospective, cohort study analyzed patient records (1984-2016) from 27 clinical sites in Europe. Outcomes included treatments received, response to first-, second- and third-line treatment, overall survival (OS) and progression-free survival (PFS). (3) Results: Of 104 patients with MF, 100 received second-line and 61 received third-line therapy. The median (range) times from the start of first-line therapy to the first R/R MF and from the first to the second R/R MF were 11.2 (0.3-166.5) and 13.5 (0.0-174.6) months, respectively. Second-and third-line treatment options varied and comprised systemic therapies (85% and 79% of patients, respectively), radiotherapy (32% and 34%, respectively) and topical therapies (48% and 36%, respectively). The median (95% confidence interval [CI]) OS from the diagnosis of the first R/R MF was 11.5 (6.5-not reached [NR]) years and was higher with non-chemotherapy (NR) versus chemotherapy (6.5 years); the estimated median PFS (95% CI) from the time of the first R/R MF was 1.3 (1.0-2.1) years. (4) Conclusions: High rates of R/R disease were observed after second- and third-line treatments in this real-world cohort, with longer median OS in patients receiving non-chemotherapy treatment versus chemotherapy. Following the standard management of MF and using recently approved targeted therapies can help improve patient outcomes in advanced-stage MF.

References

Kim Y, Bagot M, Pinter-Brown L, Rook A, Porcu P, Horwitz S . Mogamulizumab versus vorinostat in previously treated cutaneous T-cell lymphoma (MAVORIC): an international, open-label, randomised, controlled phase 3 trial. Lancet Oncol. 2018; 19(9):1192-1204. DOI: 10.1016/S1470-2045(18)30379-6. View

Kamijo H, Miyagaki T . Mycosis Fungoides and Sézary Syndrome: Updates and Review of Current Therapy. Curr Treat Options Oncol. 2021; 22(2):10. DOI: 10.1007/s11864-020-00809-w. View

Maguire A, Puelles J, Raboisson P, Chavda R, Gabriel S, Thornton S . Early-stage Mycosis Fungoides: Epidemiology and Prognosis. Acta Derm Venereol. 2019; 100(1):adv00013. PMC: 9128921. DOI: 10.2340/00015555-3367. View

Assaf C, Gellrich S, Steinhoff M, Nashan D, Weisse F, Dippel E . Cutaneous lymphomas in Germany: an analysis of the Central Cutaneous Lymphoma Registry of the German Society of Dermatology (DDG). J Dtsch Dermatol Ges. 2007; 5(8):662-8. DOI: 10.1111/j.1610-0387.2007.06337.x. View

Dobos G, De Masson A, Ram-Wolff C, Beylot-Barry M, Pham-Ledard A, Ortonne N . Epidemiological changes in cutaneous lymphomas: an analysis of 8593 patients from the French Cutaneous Lymphoma Registry. Br J Dermatol. 2020; 184(6):1059-1067. DOI: 10.1111/bjd.19644. View

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007; 147(8):573-7. DOI: 10.7326/0003-4819-147-8-200710160-00010. View

Kaufman A, Patel K, Goyal K, OLeary D, Rubin N, Pearson D . Mycosis fungoides: developments in incidence, treatment and survival. J Eur Acad Dermatol Venereol. 2020; 34(10):2288-2294. PMC: 7733543. DOI: 10.1111/jdv.16325. View

Jonak C, Tittes J, Brunner P, Guenova E . Mycosis fungoides and Sézary syndrome. J Dtsch Dermatol Ges. 2021; 19(9):1307-1334. PMC: 9293091. DOI: 10.1111/ddg.14610. View

Duarte R, Boumendil A, Onida F, Gabriel I, Arranz R, Arcese W . Long-term outcome of allogeneic hematopoietic cell transplantation for patients with mycosis fungoides and Sézary syndrome: a European society for blood and marrow transplantation lymphoma working party extended analysis. J Clin Oncol. 2014; 32(29):3347-8. DOI: 10.1200/JCO.2014.57.5597. View

10.

Olsen E, Vonderheid E, Pimpinelli N, Willemze R, Kim Y, Knobler R . Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment.... Blood. 2007; 110(6):1713-22. DOI: 10.1182/blood-2007-03-055749. View

11.

Campbell B, Scarisbrick J, Kim Y, Wilcox R, McCormack C, Prince H . Time to Next Treatment as a Meaningful Endpoint for Trials of Primary Cutaneous Lymphoma. Cancers (Basel). 2020; 12(8). PMC: 7463470. DOI: 10.3390/cancers12082311. View

12.

Olsen E . Evaluation, Diagnosis, and Staging of Cutaneous Lymphoma. Dermatol Clin. 2015; 33(4):643-54. DOI: 10.1016/j.det.2015.06.001. View

13.

Horwitz S, Scarisbrick J, Dummer R, Whittaker S, Duvic M, Kim Y . Randomized phase 3 ALCANZA study of brentuximab vedotin vs physician's choice in cutaneous T-cell lymphoma: final data. Blood Adv. 2021; 5(23):5098-5106. PMC: 9153035. DOI: 10.1182/bloodadvances.2021004710. View

14.

Dobos G, Pohrt A, Ram-Wolff C, Lebbe C, Bouaziz J, Battistella M . Epidemiology of Cutaneous T-Cell Lymphomas: A Systematic Review and Meta-Analysis of 16,953 Patients. Cancers (Basel). 2020; 12(10). PMC: 7600606. DOI: 10.3390/cancers12102921. View

15.

Yoon S, Eom G . HDAC and HDAC Inhibitor: From Cancer to Cardiovascular Diseases. Chonnam Med J. 2016; 52(1):1-11. PMC: 4742605. DOI: 10.4068/cmj.2016.52.1.1. View

16.

Maurelli M, Tessari G, Colato C, Schena D, Girolomoni G . Incidence and ten-year follow-up of primary cutaneous lymphomas: a single-centre cohort study. Eur J Dermatol. 2017; 28(1):44-49. DOI: 10.1684/ejd.2017.3183. View

17.

Lechowicz M, Lazarus H, Carreras J, Laport G, Cutler C, Wiernik P . Allogeneic hematopoietic cell transplantation for mycosis fungoides and Sezary syndrome. Bone Marrow Transplant. 2014; 49(11):1360-5. PMC: 4221526. DOI: 10.1038/bmt.2014.161. View

18.

Penate Y, Servitje O, Machan S, Fernandez-de-Misa R, Estrach M, Acebo E . The First Year of the AEVD Primary Cutaneous Lymphoma Registry. Actas Dermosifiliogr (Engl Ed). 2018; 109(7):610-616. DOI: 10.1016/j.ad.2018.03.006. View

19.

de Masson A, Beylot-Barry M, Ram-Wolff C, Mear J, Dalle S, DIncan M . Allogeneic transplantation in advanced cutaneous T-cell lymphomas (CUTALLO): a propensity score matched controlled prospective study. Lancet. 2023; 401(10392):1941-1950. DOI: 10.1016/S0140-6736(23)00329-X. View

20.

Watanabe R, Teague J, Fisher D, Kupper T, Clark R . Alemtuzumab therapy for leukemic cutaneous T-cell lymphoma: diffuse erythema as a positive predictor of complete remission. JAMA Dermatol. 2014; 150(7):776-9. PMC: 4092049. DOI: 10.1001/jamadermatol.2013.10099. View