Interventions for mycosis fungoides

Valipour, Arash; Jäger, Martin; Wu, Peggy; Schmitt, Jochen; Bunch, Charles; Weberschock, Tobias

doi:10.1002/14651858.cd008946.pub3

Cited by 19 publications

(23 citation statements)

References 147 publications

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“…One randomized clinical trial for patients with early stage MF showed no significant difference in response between PUVA monotherapy and PUVA plus bexarotene therapy 20 . Consequently, the combination of photo(chemo)therapy and bexarotene for patients with MF remains to be fully established 21 . In the present study, of the 139 patients with MF in the EAS population, the 92 (66.2%) treated with a combination of photo(chemo)therapy achieved significantly higher ORR than the 47 (33.8%) treated without a combination of photo(chemo)therapy (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of bexarotene for Japanese patients with cutaneous T‐cell lymphoma: Real‐world experience from post‐marketing surveillance

Hamada

Morita

Suga

et al. 2021

The Journal of Dermatology

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To establish real‐world evidence about the safety and efficacy of bexarotene for Japanese patients with cutaneous T‐cell lymphoma, we conducted a nationwide cohort study using data from post‐marketing surveillance for bexarotene treatment. In total, 294 patients with cutaneous T‐cell lymphoma were identified between June 2016 and June 2018. Of these, 267 patients were included as the safety analysis set. Of the 267 patients, 175 were included in the efficacy analysis set. Of these, 139 patients had mycosis fungoides, including 46 with early stage disease and 93 with advanced stage disease. Among the 139 patients with mycosis fungoides, the objective response rate was 46.8%. A significant difference in objective response rate was detected between patients who started with bexarotene at 300 mg/m2 (61.6%) and patients who started with bexarotene at less than 300 mg/m2 (22.6%, p < 0.001). Of the 139 patients with mycosis fungoides, 92 were treated with a combination of bexarotene plus photo(chemo)therapy. A significant difference in objective response rate was seen between bexarotene with a combination of photo(chemo)therapy (57.6%) and bexarotene without a combination of photo(chemo)therapy (25.5%, p < 0.001). Starting bexarotene at 300 mg/m2 and combination with photo(chemo)therapy were detected as independent factors influencing response. Common treatment‐related adverse events included hypothyroidism (85.8%), hypertriglyceridemia (68.5%), hypercholesterolemia (43.8%), and neutropenia (21.3%). Hypertriglyceridemia, hypercholesterolemia, and neutropenia occurred more frequently in patients who started with bexarotene at 300 mg/m2 than patients who started with bexarotene at less than 300 mg/m2 (hypertriglyceridemia, 76.4% vs. 57.0%, p = 0.001; hypercholesterolemia, 49.0% vs. 36.4%, p = 0.045; neutropenia, 28.0% vs. 12.1%, p = 0.002; respectively). The present study indicates that starting bexarotene at 300 mg/m2 and combination of photo(chemo)therapy offer a promising efficacy for the treatment of patients with mycosis fungoides. Efficacy of low‐dose bexarotene plus photo(chemo)therapy should be evaluated in future.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of bexarotene for Japanese patients with cutaneous T‐cell lymphoma: Real‐world experience from post‐marketing surveillance

Hamada

Morita

Suga

et al. 2021

The Journal of Dermatology

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“…Early-stage (stages IA-IIA) mycosis fungoides patients receive primarily skin targeting therapy involving topical steroids, phototherapeutic treatments (narrow-band UV-B, Psoralen plus UV-A (PUVA)), and topical mechlorethamine [ 8 , 10 , 11 , 12 ]. Treatment options for patients with progressed mycosis fungoides at advanced stages (stages IIB-IVB) are combinations of skin-directed therapy and bexarotene, interferon-α and -γ, methotrexate, and extracorporeal photochemotherapy or photopheresis (ECP).…”

Section: Introductionmentioning

confidence: 99%

“…Treatment options for patients with progressed mycosis fungoides at advanced stages (stages IIB-IVB) are combinations of skin-directed therapy and bexarotene, interferon-α and -γ, methotrexate, and extracorporeal photochemotherapy or photopheresis (ECP). Second-line therapy options include chemotherapy, total skin electron beam therapy (TSEBT), or allogeneic stem cell transplantation [ 8 , 11 , 12 ]. The remission rate, however, is much lower compared to early-stage mycosis fungoides [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

C6 Ceramide (d18:1/6:0) as a Novel Treatment of Cutaneous T Cell Lymphoma

Wilhelm

Eckes

Imre

et al. 2021

Cancers

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Cutaneous T cell lymphomas (CTCLs) represent a heterogeneous group of T cell lymphomas that primarily affect the skin. The most frequent forms of CTCL are mycosis fungoides and Sézary syndrome. Both are characterized by frequent recurrence, developing chronic conditions and high mortality with a lack of a curative treatment. In this study, we evaluated the effect of short-chain, cell-permeable C6 Ceramide (C6Cer) on CTCL cell lines and keratinocytes. C6Cer significantly reduced cell viability of CTCL cell lines and induced cell death via apoptosis and necrosis. In contrast, primary human keratinocytes and HaCaT keratinocytes were less affected by C6Cer. Both keratinocyte cell lines showed higher expressions of ceramide catabolizing enzymes and HaCaT keratinocytes were able to metabolize C6Cer faster and more efficiently than CTCL cell lines, which might explain the observed protective effects. Along with other existing skin-directed therapies, C6Cer could be a novel well-tolerated drug for the topical treatment of CTCL.

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“… 4 , 5 , 6 , 7 , 8 , 9 , 10 Within those treatment options for early-stage disease, few large, randomized, controlled studies exist, which also limits conventional systematic reviews and meta-analyses. 11 Topical therapies are the most common first-line treatments, 10 , 12 , 13 but the choice among topical steroids, retinoids, chemotherapy creams, or combination therapies may disproportionately depend on an individual dermatologist's experience and expert guidance, in addition to practical considerations such as cost and availability. To aid dermatologists in interpreting the evidence available for topical therapies for early-stage MF, we conducted a systematic review to assess the literature on their effectiveness and adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Topical treatments for early-stage mycosis fungoides using Grading Recommendations Assessment, Development and Evaluation (GRADE) criteria: A systematic review

Wennberg¹,

Richards²,

Bain³

et al. 2021

JAAD International

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Background Mycosis fungoides (MF) is a cutaneous lymphoma; most patients present with early, skin-limited disease and are managed by dermatologists. Objective The purpose of this study was to systematically review and assess the evidence on topical treatments for early-stage (IA, IB, IIA) MF. Methods We performed a literature search via MEDLINE, Embase, Web of Science, and Cochrane databases. Grading Recommendations Assessment, Development and Evaluation (GRADE) criteria were used to assess the certainty of the data. Results Two searches yielded 1252 references; 26 met the inclusion criteria and included literature on nitrogen mustard, retinoids, corticosteroids, carmustine, fluorouracil, methotrexate-laurocapram, hexadecylphosphocholine, peldesine, ingenol mebutate, topical methotrexate with oxygen flow-assisted LP3 carrier, and resiquimod. Most studies were single intervention, observational series. Nitrogen mustard, with the most published reports, was effective with 12%-82% early-stage MF patients (total n > 1000) achieving complete remission (CR) (low certainty evidence). Clinical CR was achieved among 10%-60% treated with topical retinoids (low certainty evidence). Two moderate-sized retrospective case series on topical steroids had 18%-63% CR (low certainty evidence). Only single studies were available for the other therapies. Conclusions For most outcomes of interest, the GRADE certainty for topical therapies for early-stage MF was low. Further randomized controlled trials and inclusion of quality of life indicators are needed.

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Interventions for mycosis fungoides

Cited by 19 publications

References 147 publications

Safety and efficacy of bexarotene for Japanese patients with cutaneous T‐cell lymphoma: Real‐world experience from post‐marketing surveillance

Safety and efficacy of bexarotene for Japanese patients with cutaneous T‐cell lymphoma: Real‐world experience from post‐marketing surveillance

C6 Ceramide (d18:1/6:0) as a Novel Treatment of Cutaneous T Cell Lymphoma

Topical treatments for early-stage mycosis fungoides using Grading Recommendations Assessment, Development and Evaluation (GRADE) criteria: A systematic review

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