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MF/SS: Systemic Therapy

CME

New Systemic Therapies for Mycosis Fungoides and Sézary Syndrome

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit™

Released: March 05, 2020

Expiration: March 04, 2021

Francine Foss
Francine Foss, MD
CME/CE Information

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  1. Willemze R, Jaffe ES, Burg G, et al. WHO-EORTC classification for cutaneous lymphomas. Blood. 2005;105:3768-3785.
  2. National Institutes of Health. US National Library of Medicine. Genetics Home Reference. Available at: https://ghr.nlm.nih.gov/condition/mycosis-fungoides#statistics. Accessed February 26, 2020.
  3. Zackheim HS, Amin S, Kashani-Sabet M, et al. Prognosis in cutaneous T-cell lymphoma by skin stage: long-term survival in 489 patients. J Am Acad Dermatol. 1999;40:418-425.
  4. Olsen E, Vonderheid E, Pimpinelli N, et al. 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 of Cancer (EORTC). Blood. 2007;110:1713-1722.
  5. Olsen EA, Whittaker S, Kim YH, et al. Clinical end points and response criteria in mycosis fungoides and Sézary syndrome: a consensus statement of the International Society for Cutaneous Lymphomas, the United States Cutaneous Lymphoma Consortium, and the Cutaneous Lymphoma Task Force of the European Organisation for Research and Treatment of Cancer. J Clin Oncol. 2011;29:2598-2607.
  6. Scarisbrick JJ, Hodak E, Bagot M, et al. Blood classification and blood response criteria in mycosis fungoides and Sézary syndrome using flow cytometry: recommendations from the EORTC Cutaneous Lymphoma Task Force. Eur J Cancer. 2018;93:47-56.
  7. Scarisbrick JJ, Prince HM, Vermeer MH, et al. Cutaneous lymphoma international consortium study of outcome in advanced stages of mycosis fungoides and Sézary syndrome: effect of specific prognostic markers on survival and development of a prognostic model. J Clin Oncol. 2015;33:3766-3773.
  8. Kim YH, Liu HL, Mraz-Gernahrd S. Long-term outcome of 525 patients with mycosis fungoides and Sézary syndrome: clinical prognostic factors and risk for disease progression. Arch Dermatol. 2003;139:857-866.
  9. National Cancer Institute. Mycosis fungoides (including Sézary syndrome) treatment (PDQ®) health orofessional version. Available at: https://www.cancer.gov/types/lymphoma/hp/mycosis-fungoides-treatment-pdq#_50. Accessed February 25, 2020.
  10. Willemze R, Hodak E, Zinzani PL, et al. ESMO Guidelines Committee. Primary cutaneous lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(suppl 4):iv30-iv40.
  11. Cutaneous Lymphoma Foundation. Mycosis fungoides. Available at: https://www.clfoundation.org/mycosis-fungoides. Accessed February 25, 2020.
  12. Poligone B, Heald P. Menus for managing patients with cutaneous T-cell lymphoma. Semin Cutan Med Surg. 2012;31:25-32.
  13. Nashan D, Faulhaber D, Ständer S, et al. Mycosis fungoides: a dermatological masquerader. Br J Dermatol. 2007;156:1-10.
  14. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization Classification of Lymphoid Neoplasms. Blood. 2016;127:2375-2390.
  15. Querfeld C. Mycosis fungoides and Sézary syndrome. In: O’Brian S, ed. Management of Hematologic Malignancies. Cambridge, UK: Cambridge University Press; 2011. pp 432-438.
  16. Tarabadkar ES, Shinohara MM. Skin-directed therapy in cutaneous T-cell lymphoma. Front Oncol. 2019;9:260.
  17. Kempf W, Zimmermann AK, Mitteldorf C. Cutaneous lymphomas: an update 2019. Hematol Oncol. 2019;37 9 Suppl 1:43-47.
  18. Van-de-Velde V, Zhou Y. Existing and emerging therapies for cutaneous t-cell lymphoma. J Cutan Med Surg. 2019;23:319-327.
  19. Querfeld C, Mehta N, Rosen ST, et al. Alemtuzumab for relapsed and refractory erythrodermic cutaneous T-cell lymphoma: a single institution experience from the Robert H. Lurie Comprehensive Cancer Center Leuk Lymphoma. 2009;50:1969-1976.
  20. Purnak S, Azar J, Mark LA. Etoposide as a single agent in the treatment of mycosis fungoides: a retrospective analysis. Dermatol Ther. 2018;31:e12586.
  21. Cummings FJ, Kim K, Neiman RS, et al. Phase II trial of pentostatin in refractory lymphomas and cutaneous T-cell disease. J Clin Oncol. 1991;9:565-571.
  22. Zinzani PL, Musuraca G, Tani M, et al. Phase II trial of proteasome inhibitor bortezomib in patients with relapsed or refractory cutaneous T-cell lymphoma. J Clin Oncol. 2007;25:4293-4297.
  23. Tani M, Fina M, Alinari L, et al. Phase II trial of temozolomide in patients with pretreated cutaneous T-cell lymphoma. Haematologica. 2005;90:1283-1284.
  24. Khodadoust MS, Rook AH, Porcu P, et al. Pembrolizumab in relapsed and refractory mycosis fungoides and Sézary syndrome: a multicenter phase II study. J Clin Oncol. 2020;38:20-28.
  25. Romidepsin [package insert]. Summit, NJ: Celgene Corporation; 2018.
  26. Denileukin diftitox [package insert]. Ridgefield Park, NJ: Eisai Medical Research Inc; 2008.
  27. Bexarotene [package insert]. San Diego, CA: Ligand Pharmaceuticals Inc; 2015.
  28. Vorinostat [package insert]. Whitehouse Station, NJ: Merck & Co, Inc; 2018.
  29. Brentuximab vedotin [package insert]. Bothell, WA: Seattle Genetics, Inc; 2014.
  30. Mogamulizumab [package insert]. Bedminster, NJ: Kyowa Kirin, Inc; 2018.
  31. Prince HM, Kim YH, Horwitz SM. Brentuximab vedotin or physician's choice in CD30-positive cutaneous T-cell lymphoma (ALCANZA): an international, open-label, randomised, phase 3 multicentre trial. Lancet. 2017;390:555-566.
  32. Kim YH, Prince HM, Whittaker S, et al. Superior clinical benefit of brentuximab vedotin in mycosis fungoides versus physician’s choice irrespective of CD30 level or large cell transformation status in the phase 3 ALCANZA study. Program and abstracts of the 60th ASH Annual Meeting and Exposition; December 1-4, 2018; San Diego, California. Abstract 1646.
  33. Sugaya M, Morimura S, Suga H, et al. CCR4 is expressed on infiltrating cells in lesional skin of early mycosis fungoides and atopic dermatitis. J Dermatol. 2015;42:613-615.
  34. Kim Y, Bagot M, Pinter-Brown K, et al. Mogamulizumab versus vorinostat in previously treated cutaneous T-cell lymphoma (MAVORIC): an international, open-label, randomised, controlled phase 3 trial. Lancet Oncol. 2018;19:1192-1204.
  35. Kim YH, Bagot M, Pinter-Brown L, et al. Anti-CCR4 monoclonal antibody, mogamulizumab, demonstrates significant improvement in PFS compared to vorinostat in patients with previously treated cutaneous T-cell lymphoma: results from the phase 3 MAVORIC study. Program and abstracts of the 59th ASH Annual Meeting and Exposition; December 9-12, 2017; Atlanta, Georgia. Abstract 817.
  36. Kim YH, Bagot M, Zinzani PL, et al. Safety of mogamulizumab in mycosis fungoides and Sézary syndrome: final results from the phase 3 MAVORIC study. Blood. 2019;134(suppl1). Abstract 624.
  37. ClinicalTrials.gov. A trial of E7777 in persistent and recurrent cutaneous T-cell lymphoma. Available at: https://clinicaltrials.gov/ct2/show/NCT01871727. Accessed February 25, 2020.
  38. Foss FM, Querfeld C, Kim YH, et al. Phase 1 study of cobomarsen (MRG-106) in cutaneous T cell lymphoma and HTLV-1 associated T cell leukemia/lymphoma. Program and abstracts of the 2018 ASCO Annual Meeting; June 1-5, 2018; Chicago, Illinois. Abstract 2511.
  39. ClinicalTrials.gov. SOLAR: efficacy and safety of cobomarsen (MRG-106) vs active comparator in subjects with mycosis fungoides (SOLAR). Available at: https://clinicaltrials.gov/ct2/show/NCT03713320. Accessed February 25, 2020.
  40. ClinicalTrials.gov. Safety, tolerability and pharmacokinetics of MRG-106 in patients with mycosis fungoides (MF), CLL, DLBCL or ATLL. Available at: https://clinicaltrials.gov/ct2/show/NCT02580552. Accessed February 25, 2020.
  41. Hollebecque A, Assouline S, Samaniego F, et al. Preliminary results of ASTX660, a novel non-peptidomimetic cIAP1/2 and XIAP antagonist, in 118 patients with solid tumors or lymphoma. Program and abstracts of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics, October 26-30, 2019; Boston, Massachusetts. Abstract A072.
  42. ClinicalTrials.gov. Phase 1-2 study of ASTX660 in subjects with advanced solid tumors and lymphomas. Available at: https://clinicaltrials.gov/ct2/show/NCT02503423. Accessed February 25, 2020.
  43. ClinicalTrials.gov. Study of IPH4102 in patients with relapsed/refractory cutaneous T-cell lymphomas (CTCL). Available at: https://clinicaltrials.gov/ct2/show/NCT02593045. Accessed February 25, 2020.
  44. ClinicalTrials.gov. PH4102 Alone or in combination with chemotherapy in patients with advanced T-cell lymphoma (TELLOMAK). Available at: https://clinicaltrials.gov/ct2/show/NCT03902184. Accessed February 25, 2020.
  45. Elsayad K, Stadler R, Steinbrink K, et al. Combined total skin radiotherapy and immune checkpoint inhibitors: a promising potential treatment for mycosis fungoides and Sezary syndrome. J Dtsch Dermatol Ges. 2020;[Epub ahead of print].
  46. Sivanand A, Surmanowicz P, Alhusayen R, et al. Immunotherapy for cutaneous t-cell lymphoma: current landscape and future developments. J Cutan Med Surg. 2019;23:537-544.
  47. ClinicalTrials.gov. A trial assessing the effect of pembrolizumab combined with radiotherapy in patients with relapsed, refractory, specified stages of cutaneous T-cell lymphoma (CTCL) mycosis fungoides (MF)/Sezary syndrome (SS) (PORT). Available at: https://clinicaltrials.gov/ct2/show/NCT03385226. Accessed February 25, 2020.
  48. ClinicalTrials.gov. Safety and efficacy study of a dual PI3K delta/gamma inhibitor in T-cell lymphoma. Available at: https://clinicaltrials.gov/ct2/show/NCT02567656. Accessed February 25, 2020.
  49.  Horwitz SM, Koch R, Porcu P, et al. Activity of the PI3K-δ,γ inhibitor duvelisib in a phase 1 trial and preclinical models of T-cell lymphoma. Blood. 2018;131:888-898.

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