Effective treatment of mogamulizumab-induced head and neck dermatitis with fluconazole in a patient with peripheral T-Cell lymphoma

Asokan, Ishan; Singh, Sanminder; Moesch, John; Ho, Jonhan; Akilov, Oleg E.

doi:10.1016/j.jdcr.2021.11.022

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Concerning the pathogenesis of MAR, the depletion of CCR4+ Treg cells by MOG is suggested to not only increase antitumor immunity, but also to elicit cutaneous inflammatory responses, as demonstrated in Foxp3 and CCR4 knockout murine models [70]. The blockade of CCR4 leads to impaired Treg global function and an increased inflammatory response against commensal organisms, resulting in a GVHD interface dermatitis [81], or a Th1 cell polarization along with a granulomatous dermatitis [79], which can typically appear in combined patterns [82], as Treg cells' function is to ensure tissue immune homeostasis and tolerance of commensal organisms both on the skin and in the enteric system [83]. Robust CD8 T-cell proliferation and diversification after MOG in patients with ATLL or CTCL is also associated with MAR appearance [84].…”

Section: Cutaneous Adverse Eventsmentioning

confidence: 99%

Clinical and Real-World Effectiveness of Mogamulizumab: A Narrative Review

Fernández-Guarino,

Ortiz,

Gallardo

et al. 2024

IJMS

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Mogamulizumab (MOG) is an antibody targeting the CCR4 receptor, authorized for relapsed or refractory peripheral T-cell (PTCL) and cutaneous T-cell lymphomas (CTCL). Its adoption in guidelines and endorsement by FDA and EMA established it as a systemic treatment, especially for advanced disease stages due to its comparatively lower toxicity. Clinical trials and real-world evidence have underscored its efficacy in advanced CTCLs, including mycosis fungoides and Sézary syndrome; PTCLs; and adult T-cell leukemia/lymphoma (ATLL), showcasing positive outcomes. Notably, the drug has demonstrated significant response rates, disease stability, and extended periods of progression-free survival, suggesting its applicability in cases with multiple treatment lines. Its safety profile is generally manageable, with adverse events (AEs) primarily related to the skin, infusion-related reactions, drug eruptions, autoimmune diseases, and skin disorders. The latter seem to appear as CCR4 can promote the skin-specific homing of lymphocytes, and MOG is directed against this receptor. While combination with immunostimulatory agents like interferon alpha and interleukin 12 has shown promising results, caution is urged when combining with PD1 inhibitors due to the heightened risk of immune-mediated AEs. The introduction of MOG as a systemic treatment implies a significant advancement in managing these diseases, supported by its favorable safety profile and complementary mechanisms.

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Section: Cutaneous Adverse Eventsmentioning

confidence: 99%

Clinical and Real-World Effectiveness of Mogamulizumab: A Narrative Review

Fernández-Guarino,

Ortiz,

Gallardo

et al. 2024

IJMS

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Clinicopathological definition, management and prognostic value of mogamulizumab‐associated rash and other cutaneous events: A systematic review

Avallone,

Roccuzzo,

Pileri

et al. 2024

Acad Dermatol Venereol

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Mogamulizumab is a first‐in‐class IgG1k monoclonal antibody that selectively targets the chemokine receptor type 4. The drug has received Food and Drug administration authorisation for mycosis fungoides and Sézary syndrome following failure of at least one previous course of systemic therapy and now is available in Europe. One of the most common treatment‐related side effects observed has been the mogamulizumab‐associated rash (MAR), which affects up to a quarter of patients and is the most frequent adverse event leading to drug discontinuation. The aim of this study is to perform a systematic review of the literature on patients diagnosed with MAR and other mogamulizumab‐related cutaneous events to describe the clinical and histological characteristics, the management in clinical practice and to assess whether these events have prognostic implications. In total, 2073 records were initially identified through a literature search, 843 of which were duplicates. After screening for eligibility and inclusion criteria, 49 articles reporting mogamulizumab‐associated cutaneous events were included. Totally, 1516 patients were retrieved, with a slight male prevalence as for the available data (639 males and 570 females, i.e. 52.9% vs. 47.1%). Regarding the reported clinicopathological findings of the cutaneous reactions, the five most common patterns were spongiotic/psoriasiform dermatitis (22%), eruptions characterized by the presence of papules and/or plaques (16.1%), cutaneous granulomatosis (11.4%), morbilliform or erythrodermic dermatitis (9.4%) and photodermatitis (7.1%). Our results highlight how the majority of the reported cutaneous adverse events on mogamulizumab are of mild‐to‐moderate entity and generally manageable in clinical practice, though prompt recognition is essential and case‐by‐case assessment should be recommended. Future research will need to focus on the MAR prognostic implications and to identify genomic and molecular markers for a more rapid and accurate diagnosis.

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Effective treatment of mogamulizumab-induced head and neck dermatitis with fluconazole in a patient with peripheral T-Cell lymphoma

Cited by 2 publications

References 14 publications

Clinical and Real-World Effectiveness of Mogamulizumab: A Narrative Review

Clinical and Real-World Effectiveness of Mogamulizumab: A Narrative Review

Clinicopathological definition, management and prognostic value of mogamulizumab‐associated rash and other cutaneous events: A systematic review

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