Treatment trends in advanced mycosis fungoides and Sézary syndrome

The PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study maps worldwide treatment trends in advanced mycosis fungoides (MF) and Sézary syndrome (SS). A new analysis showed that new drugs like brentuximab and mogamulizumab had favourable response rates and durable time-to-next systemic treatment (TTNsT) for advanced MF/SS.

Previously, treatment results of 853 advanced-stage MF/SS patients worldwide over 8 years (2007-2015) were published [1]. An updated analysis compared treatment approaches in the older cohort with those of a new cohort of 561 patients studied since 2015 [2]. Prof. Pietro Quaglino (University of Turin, Italy) presented the results.

The results of both cohorts revealed highly heterogeneous first-line treatment approaches. After a median follow-up of 33 months, extracorporeal photopheresis (ECP) continued to be the most frequently used first approach (21.7%). In the previous cohort, this was 18.6%. The use of interferon, bexarotene, and methotrexate also increased, while the use of chemotherapy declined.

The most often used second-line therapy was bexarotene (14.4% vs 12.8%). Prof. Quaglino noted a significant increase in the use of mogamulizumab (11.2% vs 1.2%) and brentuximab (9.8% vs 0.7%). The use of polychemotherapy markedly decreased (4.2% vs 9.2%). Bexarotene was more used in stage IIB and IVB (17.4%) while mogamulizumab was more used in stage IIIB and IVA1.

Most popular first-line treatments in advanced-stage MF/SS, were ECP (20.8%), IFN (18.3%), and bexarotene (17.4%). The relative risk of chemotherapy was potentially higher (up to 88.2%), but with a lower duration and TTNsT. As second-line therapy, Prof. Quaglino noted, mogamulizumab (9.2%) and brentuximab (10.4%) were on the rise. Of all options, mogamulizumab had the highest response rate (71.4%) and median duration (7.5 months), along with a median TTNsT of 15 months.

1. Quaglino P, et al. Ann Oncol. 2017;28(10):2517-25.
2. Roccuzzo G, et al. Treatment trends in advanced Mycosis fungoides and Sèzary syndrome: an update from the PROCLIPI study. Abstract A-189, EORTC-CLTG 2024, 9-11 October 2024, Lausanne, Switserland.

Posted on 14 October 202414 October 2024