1
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Khodadoust MS, Mou E, Kim YH. Integrating novel agents into the treatment of advanced mycosis fungoides and Sézary syndrome. Blood 2023; 141:695-703. [PMID: 36379025 DOI: 10.1182/blood.2020008241] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/04/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
Agents targeting the unique biology of mycosis fungoides and Sézary syndrome are quickly being incorporated into clinical management. With these new therapies, we are now capable of inducing more durable responses and even complete remissions in advanced disease, outcomes which were exceedingly rare with prior therapies. Yet, even this new generation of therapies typically produce objective responses in only a minority of patients. As our therapeutic options increase, we are now challenged with selecting treatments from a growing list of options. To gain the full benefit of these novel agents, we must develop strategies to match treatments for the patients most likely to benefit from them. Here, we consider both the current approaches to treatment selection based on clinical features and the future of molecular biomarker-guided therapy for patients with this heterogeneous disease.
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Affiliation(s)
- Michael S Khodadoust
- Division of Oncology, Stanford University, Stanford, CA
- Department of Dermatology, Stanford University, Stanford, CA
| | - Eric Mou
- Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA
| | - Youn H Kim
- Division of Oncology, Stanford University, Stanford, CA
- Department of Dermatology, Stanford University, Stanford, CA
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2
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Belousova IE, Gorenkova LG, Kravchenko SK, Kovrigina AM, Lepik EE, Shneyder TV. Efficacy of brentuximab vedotin in patients with CD30-positive lymphoproliferative skin diseases: results of the first prospective study in the Russian Federation. VESTNIK DERMATOLOGII I VENEROLOGII 2022. [DOI: 10.25208/vdv1319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background. Primary cutaneous lymphomas are the second most common group of extranodal lymphomas. Unlike nodal lymphomas, where B-cell proliferations dominate, primary cutaneous T-cell lymphomas account for 6575% of all cutaneous lymphomas. Among T-cell lymphomas of the skin, about 50% of cases are mycosis fungoides (MF), the second place in frequency of occurrence is occupied by CD30-positive lymphoproliferative skin diseases (CD30 LPD), about 10% are rare nosological forms, such as primary cutaneous peripheral T-cell lymphoma, unspecified, Sezari syndrome (SS), etc. During the initiating treatment of patients with MF and Szary syndrome (SS), carried out on the territory of the Russian Federation, for about 30% of patients are resistant to various therapeutic effects, especially in the later stages. The problem of the treatment of CD30+ LPD is extracutaneous dissemination in case of primary cutaneous anaplastic large cell lymphoma (pcALCL), steadily relapsing course of lymphomatoid papulosis (LyP) without symptom-free intervals. These characteristics of the therapy of cutaneous lymphomas demand for the need to search for new treatment options. Brentuximab vedotin, according to the results of the international randomized ALCANZA trial, has shown high efficiency in the treatment of cutaneous T-cell lymphoproliferative diseases.
Aim. To evaluate the efficacy of brentuximab vedotin application in patients with cutaneous T-cell lymphomas in adverse risk group received at least one line of systemic therapy.
Materials and methods. The study included 21 patients: 16 men and 5 women. The diagnosis of MF was verified in 8 patients, SS in 5 patients, cutaneous CD30+ LPD in 6 patients (5 patients pcALCL, 1 patient LyP) and a primary cutaneous peripheral T-cell lymphoma, unspecified in 2 patients. The diagnosis of cutaneous T-cell lymphoma was verified on the basis of the anamnesis of the disease, on the character of cutaneous lesions, on histological, immunohistochemical and in some cases on molecular genetic testing of the skin biopsy (the assessment of T-cell receptor gene rearrangement).
Results. The late stages of the disease were diagnosed in 12 of 13 patients with MF/SS. Extracutaneous lesions were diagnosed in 57% of cases. The median of prior lines therapy was 3 (18 variants of treatment). The overall response to the treatment was achieved in 91% of cases (in 19 of 21 patients): the complete remission was obtained in 53% of cases, very good partial remission in 31% of cases and partial remission in 16% of cases. The progression of the disease was determined in 2 patients (after the first and fourth cycles). Some patients with partial remission as a result of therapy using brentuximab vedotin had the additional therapy (radiation therapy, interferon , the cycles of systemic therapy) and these acts gave an option of achieving deeper antitumor response. The early relapse was diagnosed in 2 of 19 patients who had responded to the treatment. The treatment tolerability was acceptable, and the toxicity did not exceed the already known one described in earlier studies. Thus, the stable overall antitumor response had been persisting in 89% of patients (the median of the observation was 10 months).
Conclusion. The use of targeted therapy with brentuximab vedotin gave an option of achieving high treatment results in group of patients with advanced stages of the disease and inefficiency of several lines of therapy.
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3
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[Translated article] Advanced-Stage CD30+ Mycosis Fungoides Treated With Brentuximab. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2020.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] Open
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4
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Vico-Alonso C, Andrés-Lencina J, Rodríguez-Peralto J, Ortiz Romero P. Micosis fungoides en estadio avanzado CD30+ tratadas con brentuximab. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:529-531. [DOI: 10.1016/j.ad.2020.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/27/2020] [Accepted: 05/25/2020] [Indexed: 11/28/2022] Open
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5
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Gorenkova LG, Belousova IE, Kravchenko SK, Kovrigina AM, Sidorova YV, Ryzhikova NV, Lepik EE, Shneyder TV. Modern possibilities of therapy for primary cutaneous T-cell lymphomas: the first results of the use of brentuximab vedotin in the Russian Federation. JOURNAL OF MODERN ONCOLOGY 2021. [DOI: 10.26442/18151434.2021.3.201204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background. Primary cutaneous T-cell lymphomas are rare heterogeneous group of lymphoproliferative diseases characterized by primarily involving skin and subcutaneous adipose tissue. Half of these cases are mycosis fungoides (MF), for about 25% are cutaneous CD30+ lymphoproliferative diseases (CD30+ LPD): primary cutaneous anaplastic large cell lymphoma (pcALCL) and lymphomatoid papulosis (LyP). During the initiating treatment of patients with MF and Szary syndrome (SS), carried out on the territory of the Russian Federation, for about 30% of patients are resistant to various therapeutic effects, especially in the later stages. The problem of the treatment of CD30+ LPD is extracutaneous dissemination in case of pcALCL, steadily relapsing course of LyP without symptom-free intervals. These characteristics of the therapy of cutaneous lymphomas demand for the need to search for new treatment options. Brentuximab vedotin, according to the results of the international randomized ALCANZA trial, has shown high efficiency in the treatment of cutaneous T-cell lymphoproliferative diseases.
Aim. To evaluate the efficacy of brentuximab vedotin application in patients with cutaneous T-cell lymphomas in adverse risk group received at least one line of systemic therapy.
Materials and methods. The study included 21 patients: 16 men and 5 women. The diagnosis of MF was verified in 8 patients, SS in 5 patients, cutaneous CD30+ LPD in 6 patients (5 patients pcALCL, 1 patient LyP) and a primary cutaneous peripheral T-cell lymphoma, unspecified in 2 patients. The diagnosis of cutaneous T-cell lymphoma was verified on the basis of the anamnesis of the disease, on the character of cutaneous lesions, on histological, immunohistochemical and in some cases on molecular genetic testing of the biopted sample of the skin (the assessment of T-cell receptor gene rearrangement).
Results. The late stages of the disease were diagnosed in 12 of 13 patients with MF/SS. Extracutaneous lesions were diagnosed in 57% of cases. The median of prior lines therapy was 3 (18 variants of treatment). The overall response to the treatment was achieved in 91% of cases (in 19 of 21 patients): the complete remission was obtained in 53% of cases, very good partial remission in 31% of cases and partial remission in 16% of cases. The progression of the disease was determined in 2 patients (after the first and fourth cycles). Some patients with partial remission as a result of therapy using brentuximab vedotin had the additional therapy (radiation therapy, interferon , the cycles of systemic therapy) and these acts gave an option of achieving deeper antitumor response. The early relapse was diagnosed in 2 of 19 patients who had responded to the treatment. The treatment tolerability was acceptable, and the toxicity did not exceed the already known one described in earlier studies. Thus, the stable overall antitumor response had been persisting in 89% of patients (the median of the observation was 10 months).
Conclusion. The use of targeted therapy with brentuximab vedotin gave an option of achieving high treatment results in group of patients with advanced stages of the disease and inefficiency of several lines of therapy.
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6
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Gundogan B, Dowlut N, Rajmohan S, Borrelli MR, Millip M, Iosifidis C, Udeaja YZ, Mathew G, Fowler A, Agha R. Assessing the compliance of systematic review articles published in leading dermatology journals with the PRISMA statement guidelines: A systematic review. JAAD Int 2021; 1:157-174. [PMID: 34409336 PMCID: PMC8361930 DOI: 10.1016/j.jdin.2020.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2020] [Indexed: 11/24/2022] Open
Abstract
Background Reporting quality of systematic reviews and meta-analyses is of critical importance in dermatology because of their key role in informing health care decisions. Objective To assess the compliance of systematic reviews and meta-analyses in leading dermatology journals with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. Methods This review was carried out in accordance with PRISMA guidelines. Included studies were reviews published across 6 years in the top 4 highest-impact-factor dermatology journals of 2017. Records and full texts were screened independently. Data analysis was conducted with univariate multivariable linear regression. The primary outcome was to assess the compliance of systematic reviews and meta-analyses in leading dermatology journals with the PRISMA statement. Results A total of 166 studies were included and mean PRISMA compliance across all articles was 73%. Compliance significantly improved over time (β = .016; P = <.001). The worst reported checklist item was item 5 (reporting on protocol existence), with a compliance of 15% of articles. Conclusion PRISMA compliance within leading dermatology journals could be improved; however, it is steadily improving.
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Affiliation(s)
- Buket Gundogan
- University College London Hospital, London, United Kingdom
| | - Naeem Dowlut
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | | | - Mimi R Borrelli
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Mirabel Millip
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Christos Iosifidis
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yagazie Z Udeaja
- Luton and Dunstable University Hospital NHS Foundation Trust, Luton, United Kingdom
| | - Ginimol Mathew
- University College London Medical School, Gower Street, London, United Kingdom
| | | | - Riaz Agha
- Bart's Health NHS Foundation Trust, London, United Kingdom
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7
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Papadavid E, Kapniari E, Pappa V, Nikolaou V, Iliakis T, Dalamaga M, Jonak C, Porkert S, Engelina S, Quaglino P, Ortiz-Romero PL, Vico C, Cozzio A, Dimitriou F, Guiron R, Guenova E, Hodak E, Bagot M, Scarisbrick J. Multicentric EORTC retrospective study shows efficacy of brentuximab vedotin in patients who have mycosis fungoides and Sézary syndrome with variable CD30 positivity. Br J Dermatol 2021; 185:1035-1044. [PMID: 34137025 DOI: 10.1111/bjd.20588] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Brentuximab vedotin (BV) was approved as a therapy for mycosis fungoides (MF) based on the ALCANZA trial. Little real-world data, however, are available. OBJECTIVES To evaluate the efficacy and safety of BV in patients with MF/Sézary Syndrome (SS) with variable CD30 positivity in a real-world cohort and to explore potential predictors of response. METHODS Data from 72 patients with MF/SS across nine EORTC (European Organization for Research and Treatment of Cancer) centres were included. The primary endpoint was to evaluate the proportion of patients with: overall response (ORR), ORR lasting over 4 months (ORR4), time to response (TTR), response duration (RD), progression-free survival (PFS) and time to next treatment (TTNT). Secondary aims included a safety evaluation and the association of clinicopathological features with ORR, RD and TTNT. RESULTS All 72 patients had received at least one systemic treatment. ORR was achieved in 45 of 67; ORR4 in 28 of 67 with a median TTR of 8 weeks [interquartile range (IQR) 5·5-14] and with a median RD of 9 months (IQR 3·4-14). Median PFS was 7 months (IQR 2-12) and median TTNT was 30 days (6-157·5). Patient response, RD, PFS and TTNT were not associated with any clinicopathological characteristics. In the MF group, patients with stage IIB/III vs. IV achieved longer PFS and had a higher percentage of ORR4. There was a statistically significant association between large-cell transformation and skin ORR (P = 0·03). ORR4 was more frequently achieved in patients without lymph node involvement (P = 0·04). CONCLUSIONS BV is an effective option for patients with MF/SS, including those with variable CD30 positivity, large-cell transformation, SS, longer disease duration and who have been treated previously with several therapies.
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Affiliation(s)
- E Papadavid
- 1st and 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - E Kapniari
- 1st and 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - V Pappa
- 1st and 2nd Propaedeutic Department, Hematology Units, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - V Nikolaou
- 1st and 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - T Iliakis
- 1st and 2nd Propaedeutic Department, Hematology Units, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - M Dalamaga
- 1st Department of Biological Chemistry, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - C Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - S Porkert
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - S Engelina
- Division of Dermatology, Tel Aviv University, Israel
| | - P Quaglino
- Division of Dermatology, Tel Aviv University, Israel
| | - P L Ortiz-Romero
- Dermatologic Clinic, Department of Medical Sciences, University of Turin Medical School, Turin, Italy
| | - C Vico
- Department of Dermatology, 12 de Octubre Hospital, Medical School, University Compultense, Madrid, Spain
| | - A Cozzio
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - F Dimitriou
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - R Guiron
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Tel Aviv University, Israel
| | - E Guenova
- Department of Dermatology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - E Hodak
- Division of Dermatology, Tel Aviv University, Israel
| | - M Bagot
- Dermatology Department, APHP, Saint-Louis Hospital, Université de Paris, Paris, France.,Inserm U976, Paris, France
| | - J Scarisbrick
- Department of Dermatology, Centre for Rare Diseases, University Hospital Birmingham, Birmingham, UK
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8
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Oh Y, Stoll JR, Moskowitz A, Pulitzer M, Horwitz S, Myskowski P, Noor SJ. Article Topic/Title: Primary cutaneous T-cell lymphomas other than Mycosis Fungoides and Sezary Syndrome. Part II: Prognosis and Management. J Am Acad Dermatol 2021; 85:1093-1106. [PMID: 33945836 DOI: 10.1016/j.jaad.2021.04.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 10/21/2022]
Abstract
Primary cutaneous T-cell lymphomas (CTCLs) other than Mycosis Fungoides (MF) and Sézary syndrome (SS) encompass a heterogenous group of non-Hodgkin lymphomas with variable clinical course, prognoses, and management. With morphologic and histologic overlap among the CTCL subtypes and other T-cell lymphomas with cutaneous manifestations, thorough evaluation with clinicopathologic correlation and exclusion of systemic involvement are essential prior to initiating therapy. Staging and treatment recommendations vary depending on the subtype, clinical behavior, and treatment response. Generally, for subtypes where staging is recommended, Ann Arbor or TNM staging specific to CTCL other than MF or SS are used. For many subtypes, there is no standard treatment to date. Available recommended treatments range widely from no active or minimal intervention with skin-directed therapy to aggressive systemic therapies including multiagent chemotherapy with consideration for hematopoietic stem cell transplant. Emerging targeted therapies, such as brentuximab, a chimeric antibody targeting CD30, show promise in altering the disease course of non-MF/SS CTCLs.
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Affiliation(s)
- Yuna Oh
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | | | - Sarah J Noor
- Memorial Sloan Kettering Cancer Center, New York, NY.
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9
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Stranzenbach R, Stadler R. Kombination aus Brentuximab‐Vedotin und hautspezifischen Therapien verlängert bei Patienten mit kutanem T‐Zell‐Lymphom die Zeit bis zur nächsten Therapieeskalation. J Dtsch Dermatol Ges 2021; 19:383-388. [PMID: 33709582 DOI: 10.1111/ddg.14342_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- René Stranzenbach
- Universitätsklinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Johannes Wesling Klinikum, Universitätsklinikum der Ruhr-Universität Bochum
| | - Rudolf Stadler
- Universitätsklinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Johannes Wesling Klinikum, Universitätsklinikum der Ruhr-Universität Bochum
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10
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Stranzenbach R, Stadler R. Combination of brentuximab-vedotin with skin-directed therapies extends the time to the next therapeutic line in patients with cutaneous T-cell lymphoma. J Dtsch Dermatol Ges 2021; 19:383-387. [PMID: 33617153 DOI: 10.1111/ddg.14342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/06/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Brentuximab vedotin (BV) is a potent therapeutic option for CD30-positive cutaneous T-cell lymphoma. Unlike existing studies, BV and other therapeutic procedures were frequently combined for our patients. In this context, the study aims to analyze the effectiveness and safety of BV in a real-world setting. PATIENTS AND METHODS This is a retrospective monocentric study analyzing treatment outcomes for patients with CD30-positive cutaneous T-cell lymphoma treated with BV. RESULTS 26 patients (median age: 67 years) were included in the study. Patients were treated with 1.8 or 1.2 mg/kg b.w. Complete remission (CR) was reached in 30.8 % of the patients, and the objective response rate (ORR) was 84.6 %. Side effects were seen in 19 of the 26 patients. As a reaction to progressive disease (PD) under BV monotherapy, we included skin-directed procedures such as tumor excision, local radiotherapy, and PUVA for six patients. We re-stabilized the disease and maintained the line of therapy without additional toxicities for a median of seven months longer using this concept. CONCLUSIONS Addition of skin-directed therapies (SDT) after disease progression under BV monotherapy could stabilize the disease's continuous advancement or even lead to partial response, thereby extending the time until the next therapeutic escalation.
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Affiliation(s)
- René Stranzenbach
- Department of Dermatology, Venerology, Allergology and Phlebology, Johannes Wesling Medical Centre, University Hospital of Ruhr-University Bochum, Germany
| | - Rudolf Stadler
- Department of Dermatology, Venerology, Allergology and Phlebology, Johannes Wesling Medical Centre, University Hospital of Ruhr-University Bochum, Germany
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11
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Stranzenbach R. How do we treat cutaneous T-cell lymphoma? Ital J Dermatol Venerol 2020; 156:534-544. [PMID: 32938164 DOI: 10.23736/s2784-8671.20.06606-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cutaneous T-cell lymphomas are a heterogeneous group of non-Hodgkin lymphomas which are based on the malignant proliferation of skin-related T lymphocytes. The clinical appearance, as well as the course and the associated therapeutic approach, are sometimes very different between the different subtypes. Since allogeneic stem cell transplantation is currently the only curative option, and the morbidity and mortality are not insignificant, a therapy concept should be developed that considers its often rather indolent but chronic course. This concept should enable a good disease control with as few side effects as possible and preserve or improve the quality of life. In the early stages of the disease, skin-oriented therapies are generally used first before systemic and increasingly aggressive therapeutic agents are used as the disease progresses. Considering the current guidelines, literature and subjective experience, we summarize in this review how we treat cutaneous T-cell lymphomas.
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Affiliation(s)
- René Stranzenbach
- Department of Dermatology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany -
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12
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Engelina S, Saggu M, Yoo J, Shah F, Stevens A, Irwin C, Chaganti S, Scarisbrick J. Brentuximab a novel antibody therapy: real‐world use confirms efficacy and tolerability for CD30‐positive cutaneous lymphoma. Br J Dermatol 2019; 182:799-800. [DOI: 10.1111/bjd.18535] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S. Engelina
- University Hospital Birmingham (UHB) Birmingham U.K
| | - M. Saggu
- University Hospital Birmingham (UHB) Birmingham U.K
| | - J. Yoo
- University Hospital Birmingham (UHB) Birmingham U.K
| | - F. Shah
- University Hospital Birmingham (UHB) Birmingham U.K
| | - A. Stevens
- University Hospital Birmingham (UHB) Birmingham U.K
| | - C. Irwin
- University Hospital Birmingham (UHB) Birmingham U.K
| | - S. Chaganti
- University Hospital Birmingham (UHB) Birmingham U.K
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14
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Primary Cutaneous Anaplastic Large Cell Lymphoma of the Oral Cavity Successfully Treated with Brentuximab Vedotin. Case Rep Hematol 2019; 2019:9651207. [PMID: 31637066 PMCID: PMC6766127 DOI: 10.1155/2019/9651207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/20/2019] [Accepted: 09/05/2019] [Indexed: 11/24/2022] Open
Abstract
Primary cutaneous anaplastic large cell lymphoma is a CD-30 positive lymphoproliferative disorder with good prognosis, usually treated with radiation therapy and surgery. Head, neck, and extremities are the most frequently involved sites. In this paper, we describe an unusual case of oral localization, recurring after skin-involving radiotherapy, successfully treated with sixteen cycles of brentuximab vedotin. This could be a more effective approach with a less detrimental toll for treating these rare disorders.
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15
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Abstract
Primary cutaneous lymphomas (CL) are the second most common form of extranodal lymphomas. Cutaneous T-cell lymphomas represent the majority. They are classified according to the WHO classification 2017 and the updated WHO-EORTC 2018 published in the fourth edition of the WHO classification for Skin Tumors monograph. Primary cutaneous acral CD8+ T-cell lymphoma and EBV-positive mucocutaneous ulcer have been listed as new provisional entities. Moreover, the histological and genetic spectrum of lymphomatoid papulosis has been expanded. Recently, prognostic subtypes were delineated for some entities and subtypes of CL such as folliculotropic mycosis fungoides and marginal zone lymphoma. Since CL show overlapping histological features, clinico-pathological correlation is of outmost importance for the diagnosis. Recent studies revealed new biomarkers and genetic alterations underlying the pathogenesis of CL. Moreover, targeted therapies have widened the treatment options particularly for aggressive lymphomas.
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Affiliation(s)
- Werner Kempf
- Kempf und Pfaltz Histologische Diagnostik, Zurich, Switzerland.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | | | - Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Medical Center, Göttingen, Germany
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16
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RF - Brentuximab as Treatment for CD30 + Primary Cutaneous Lymphoma. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:769-770. [PMID: 31151669 DOI: 10.1016/j.ad.2018.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/21/2018] [Accepted: 03/27/2018] [Indexed: 11/20/2022] Open
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17
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Pileri A, Starace M, Alessandrini A, Casadei B, Zinzani P, Piraccini B. New therapies and old side‐effects in mycosis fungoides treatment: brentuximab vedotin‐induced alopecia. Br J Dermatol 2019; 180:1535-1536. [DOI: 10.1111/bjd.17533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Pileri
- Dermatology Unit Department of Experimental Diagnostic and Speciality Medicine University of Bologna Via Massarenti 1 Bologna Italy
| | - M. Starace
- Dermatology Unit Department of Experimental Diagnostic and Speciality Medicine University of Bologna Via Massarenti 1 Bologna Italy
| | - A. Alessandrini
- Dermatology Unit Department of Experimental Diagnostic and Speciality Medicine University of Bologna Via Massarenti 1 Bologna Italy
| | - B. Casadei
- Hematology Unit Department of Experimental, Diagnostic and Speciality Medicine University of Bologna Via Massarenti 9 Bologna Italy
| | - P.L. Zinzani
- Hematology Unit Department of Experimental, Diagnostic and Speciality Medicine University of Bologna Via Massarenti 9 Bologna Italy
| | - B.M. Piraccini
- Dermatology Unit Department of Experimental Diagnostic and Speciality Medicine University of Bologna Via Massarenti 1 Bologna Italy
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18
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Dereure O. [Primary skin lymphomas: Current therapy]. Ann Dermatol Venereol 2019; 146:92-99. [PMID: 30709635 DOI: 10.1016/j.annder.2018.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/16/2018] [Accepted: 11/21/2018] [Indexed: 11/24/2022]
Abstract
Therapeutic progress in primary cutaneous lymphomas continues to be largely dominated by the T-cell lymphomas, towards which the great majority of recent therapeutic innovations have been directed. The latter include local treatments consisting either of relatively classical but "revamped" approaches involving different pharmaceutical forms (example: chlormethine gel) or else lower but seemingly equally effective dosages (electron therapy), or of more innovative approaches (example: UVA-1, dynamic phototherapy, imiquimod, resimiquimod). However, significant progress has been made chiefly in terms of systemic treatments with the emergence of "targeted" drugs that directly and specifically target tumour cells (monoclonal antibodies directed against CD30, CCR4 or CD158k) and the further development of "small" molecules such as histone deacetylase inhibitors and new cytostatics. Immunotherapies, which have proven so effective in other areas of oncodermatology, are also of great interest, while allogeneic haematopoietic stem-cell transplantation has clearly shown its superiority over autologous transplantation and now constitutes a significant component of the therapeutic arsenal in advanced disease. While the innovations in terms of B-cell lymphomas are certainly less significant, mention must also be made of the value of rituximab combined with polychemotherapy (CHOP) and of lenalidomide (as second-line therapy) in primary cutaneous diffuse large B-cell lymphoma, leg type, along with the development of localized (very) low-dose radiotherapy in unilesional or paucilesional indolent forms.
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Affiliation(s)
- O Dereure
- Unité Inserm U1058, département de dermatologie, université Montpellier, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
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19
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Kempf W. Multifocal anaplastic large cell lymphoma - insight into its biology and treatment. Br J Dermatol 2018; 179:565-566. [PMID: 30222874 DOI: 10.1111/bjd.16814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- W Kempf
- Kempf und Pfaltz Histologische Diagnostik, Affolternstrasse 56, CH-8050, Zürich, Switzerland.,Department of Dermatology, University Hospital, CH-8091, Zürich, Switzerland
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20
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Melchers R, Willemze R, Bekkenk M, de Haas E, Horvath B, van Rossum M, Sanders C, Veraart J, Vermeer M, Quint K. Evaluation of treatment results in multifocal primary cutaneous anaplastic large cell lymphoma: report of the Dutch Cutaneous Lymphoma Group. Br J Dermatol 2018; 179:724-731. [DOI: 10.1111/bjd.16501] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2018] [Indexed: 11/27/2022]
Affiliation(s)
- R.C. Melchers
- Department of Dermatology; Leiden University Medical Center; the Netherlands
| | - R. Willemze
- Department of Dermatology; Leiden University Medical Center; the Netherlands
| | - M.W. Bekkenk
- Department of Dermatology; Academic Medical Center and Vrije University Medical Center; Amsterdam the Netherlands
| | - E.R.M. de Haas
- Department of Dermatology; Erasmus Medical Center; Rotterdam the Netherlands
| | - B. Horvath
- Department of Dermatology; University Medical Center of Groningen; the Netherlands
| | - M.M. van Rossum
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - C.J.G. Sanders
- Department of Dermatology; University Medical Center Utrecht; the Netherlands
| | - J.C.J.M. Veraart
- Department of Dermatology; Maastricht University Medical Center; the Netherlands
| | - M.H. Vermeer
- Department of Dermatology; Leiden University Medical Center; the Netherlands
| | - K.D. Quint
- Department of Dermatology; Leiden University Medical Center; the Netherlands
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21
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Scarisbrick JJ. Brentuximab vedotin is an effective therapy for CD30 + mycosis fungoides and cutaneous anaplastic large-cell lymphoma: what is the cost? Br J Dermatol 2018; 177:1474-1475. [PMID: 29313932 DOI: 10.1111/bjd.16033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Wagh A, Song H, Zeng M, Tao L, Das TK. Challenges and new frontiers in analytical characterization of antibody-drug conjugates. MAbs 2018; 10:222-243. [PMID: 29293399 DOI: 10.1080/19420862.2017.1412025] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Antibody-drug conjugates (ADCs) are a growing class of biotherapeutics in which a potent small molecule is linked to an antibody. ADCs are highly complex and structurally heterogeneous, typically containing numerous product-related species. One of the most impactful steps in ADC development is the identification of critical quality attributes to determine product characteristics that may affect safety and efficacy. However, due to the additional complexity of ADCs relative to the parent antibodies, establishing a solid understanding of the major quality attributes and determining their criticality are a major undertaking in ADC development. Here, we review the development challenges, especially for reliable detection of quality attributes, citing literature and new data from our laboratories, highlight recent improvements in major analytical techniques for ADC characterization and control, and discuss newer techniques, such as two-dimensional liquid chromatography, that have potential to be included in analytical control strategies.
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Affiliation(s)
- Anil Wagh
- a Molecular & Analytical Development , Bristol-Myers Squibb , New Jersey , USA
| | - Hangtian Song
- a Molecular & Analytical Development , Bristol-Myers Squibb , New Jersey , USA
| | - Ming Zeng
- a Molecular & Analytical Development , Bristol-Myers Squibb , New Jersey , USA
| | - Li Tao
- a Molecular & Analytical Development , Bristol-Myers Squibb , New Jersey , USA
| | - Tapan K Das
- a Molecular & Analytical Development , Bristol-Myers Squibb , New Jersey , USA
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23
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Geller S, Myskowski P, Kim Y, Moskowitz A, Horwitz S. The optimal regimen of brentuximab vedotin for CD30+
cutaneous lymphoma: are we there yet? Br J Dermatol 2017; 178:571. [DOI: 10.1111/bjd.16052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S. Geller
- Dermatology Service; Department of Medicine; Memorial Sloan-Kettering Cancer Center and Weill Cornell Medicine; New York NY U.S.A
| | - P.L. Myskowski
- Dermatology Service; Department of Medicine; Memorial Sloan-Kettering Cancer Center and Weill Cornell Medicine; New York NY U.S.A
| | - Y.H. Kim
- Department of Dermatology; Stanford University School of Medicine; Stanford CA U.S.A
| | - A. Moskowitz
- Lymphoma Service; Department of Medicine; Memorial Sloan-Kettering Cancer Center and Weill Cornell Medicine; New York NY U.S.A
| | - S. Horwitz
- Lymphoma Service; Department of Medicine; Memorial Sloan-Kettering Cancer Center and Weill Cornell Medicine; New York NY U.S.A
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24
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Lewis DJ, Kim YH, Duvic M. Alternate dosing regimens of brentuximab vedotin for CD30+ cutaneous T-cell lymphoma. Br J Dermatol 2017; 178:302-303. [PMID: 28889405 DOI: 10.1111/bjd.15970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- D J Lewis
- School of Medicine, Baylor College of Medicine, Houston, TX, U.S.A.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, U.S.A
| | - Y H Kim
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA, U.S.A
| | - M Duvic
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, U.S.A
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