Phase II trial of fludarabine phosphate and interferon alfa-2a in advanced mycosis fungoides/Sézary syndrome.

Foss, Francine M.; Ihde, Daniel C.; Linnoila, Ilona; Fischmann, A. B.; Schechter, GP; Cotelingam, James D.; Steinberg, S. M.; Ghosh, Bimal C.; Stocker, J.; Bastian, Anne

doi:10.1200/jco.1994.12.10.2051

Cited by 88 publications

(48 citation statements)

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“…Responses, which may be achieved within a few months, are observed in patients with tumor-stage MF and SS. Furthermore, interferon-alpha may be successfully combined with a number of other therapeutic modalities, including PUVA, bexarotene, chemotherapy and ECP, which are frequently utilized in the management of these patients [289][290][291][292][293][294][295][296][297][298][299][300][301][302]. For example, in a cohort of 51 patients (42 of which had advancedstage disease) treated with single-agent, low-dose, interferon-alpha, responses were observed in 34 (67%), 21 (41%) of which were complete and maintained long-term in nine patients [288].…”

Section: Interferon-alphamentioning

confidence: 99%

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Wilcox

2011

American J Hematol

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Disease overview: Cutaneous T‐cell lymphomas are a heterogenous group of T‐cell lymphoproliferative disorders involving the skin, the majority of which may be classified as Mycosis fungoides (MF) or Sézary syndrome (SS).Diagnosis: The diagnosis of MF or SS requires the integration of clinical and histopathologic data.Risk‐adapted therapy: Tumor, node, metastasis, and blood (TNMB) staging remains the most important prognostic factor in MF/SS and forms the basis for a “risk‐adapted,” multidisciplinary approach to treatment. For patients with disease limited to the skin, expectant management or skin‐directed therapies is preferred, as both disease‐specific and overall survival for these patients is favorable. In contrast, patients with advanced‐stage disease with significant nodal, visceral, or blood involvement are generally approached with biologic‐response modifiers, denileukin diftitox, and histone deacetylase inhibitors before escalating therapy to include systemic, single‐agent chemotherapy. Multiagent chemotherapy may be used for those patients with extensive visceral involvement requiring rapid disease control. In highly‐selected patients with disease refractory to standard treatments, allogeneic stem‐cell transplantation may be considered. Am. J. Hematol., 2011. © 2011 Wiley‐Liss, Inc.

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Section: Interferon-alphamentioning

confidence: 99%

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Wilcox

2011

American J Hematol

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“…[51][52][53] Time to response is in the order of weeks, and it can be combined with PUVA, chemotherapy, retinoids, and bexarotene. 30,31,41,42,46,50,54,55 In advanced-stage disease, our preference is to use single-agent IFN-␣ first, adding PUVA if there is more widespread pruritus and adding bexarotene if the response is suboptimal. Prolonged responses have also been observed with ␥-interferon.…”

Section: Ifn-␣ and Related Biologic Response Modifiersmentioning

confidence: 99%

How I treat mycosis fungoides and Sézary syndrome

Prince

Whittaker

Hoppe

2009

Blood

135

109

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The most common subtypes of primary cutaneous T-cell lymphomas are mycosis fungoides (MF) and Sézary syndrome (SS). The majority of patients have indolent disease; and given the incurable nature of MF/SS, management should focus on improving symptoms and cosmesis while limiting toxicity. Management of MF/SS should use a “stage-based” approach; treatment of early-stage disease (IA-IIA) typically involves skin directed therapies that include topical corticosteroids, phototherapy (psoralen plus ultraviolet A radiation or ultraviolet B radiation), topical chemotherapy, topical or systemic bexarotene, and radiotherapy. Systemic approaches are used for recalcitrant early-stage disease, advanced-stage disease (IIB-IV), and transformed disease and include retinoids, such as bexarotene, interferon-α, histone deacetylase inhibitors, the fusion toxin denileukin diftitox, systemic chemotherapy including transplantation, and extracorporeal photopheresis. Examples of drugs under active investigation include new histone deacetylase inhibitors, forodesine, monoclonal antibodies, proteasome inhibitors, and immunomodulatory agents, such as lenalidomide. It is appropriate to consider patients for novel agents within clinical trials if they have failed front-line therapy and before chemotherapy is used.

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“…Fludarabine has been used in 4 studies in advanced CTCL, [29][30][31][32] with an overall response rate of 20% to 51% and a higher response rate when combined with extracorporeal photopheresis (63%). 32 Methotrexate has been tested for the same indication in 4 studies.…”

Section: Commentmentioning

confidence: 99%

Prospective Multicenter Study of Pegylated Liposomal Doxorubicin Treatment in Patients With Advanced or Refractory Mycosis Fungoides or Sézary Syndrome

Quéreux

Marques²,

Nguyen³

et al. 2008

Arch Dermatol

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Phase II trial of fludarabine phosphate and interferon alfa-2a in advanced mycosis fungoides/Sézary syndrome.

Cited by 88 publications

References 0 publications

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

How I treat mycosis fungoides and Sézary syndrome

Prospective Multicenter Study of Pegylated Liposomal Doxorubicin Treatment in Patients With Advanced or Refractory Mycosis Fungoides or Sézary Syndrome

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