EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome – Update 2023

Latzka, Johanna; Assaf, Chalid; Bagot, Martine; Cozzio, Antonio; Dummer, Reinhard; Guenova, Emmanuella; Gniadecki, Robert; Hodak, Emmilia; Jonak, Constanze; Klemke, Claus-Detlev; Knobler, Robert; Morrris, Stephen; Nicolay, Jan P.; Ortiz-Romero, Pablo L.; Papadavid, Evangelia; Pimpinelli, Nicola; Quaglino, Pietro; Ranki, Annamari; Scarisbrick, Julia; Stadler, Rudolf; Väkevä, Liisa; Vermeer, Maarten H.; Wehkamp, Ulrike; Whittaker, Sean; Willemze, Rein; Trautinger, Franz

doi:10.1016/j.ejca.2023.113343

Cited by 56 publications

(22 citation statements)

References 214 publications

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“…CL gel is the first skin-directed therapy purposely developed for the treatment of MF and is currently recommended as first-line therapy for treating adult patients with MF by international guidelines ( 1 , 9 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…Our study included 79 patients, representing one of the largest patient cohorts in reference to available real-life studies. In our cohort, most patients were in the early stage (84%), and CL gel was mainly prescribed in combination with TCS (66% of patients), according to the guidelines ( 9 – 11 ). In 92% of cases, advanced-stage patients followed a concomitant therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Guidelines for the treatment of MF are based on the stage of the disease and primarily aim to reduce symptoms, prevent disease progression, and improve the quality of life (QoL) ( 8 ). Currently, topical chlormethine (CL), an alkylating agent used successfully in the treatment of cutaneous T-cell lymphoma since the 1950s, represents the first-line treatment for early-stage patients, according to recommendations by the National Comprehensive Cancer Network and international guidelines ( 1 , 9 – 11 ). CL acts by a cytotoxic mechanism on DNA, predominantly altering the neoplastic cell growth and increasing the immunogenic potential of the host ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness and tolerability of chlormethine gel for the management of mycosis fungoides: a multicenter real-life evaluation

Alberti-Violetti,

Ardigò,

Massone

et al. 2024

Front. Oncol.

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BackgroundTopical chlormethine (CL) is recommended as a first-line treatment for early-stage mycosis fungoides (MF) and in 2017, the European Medicines Agency approved the CL gel formulation to treat adult patients. More recently, to increase patient compliance and adherence, clinicians have developed flexible protocols that allow the concomitant use of CL gel with topical corticosteroids in daily practice regimens. Therefore, sharing real-life data on CL gel use and side effects management may help improve the use of this agent.ObjectivesTo expand knowledge about the actual use of CL gel in patients with MF, the present study assessed the improvement of MF skin lesions after CL gel treatment and provided information on the management of cutaneous adverse events (AEs) in a real-life setting.MethodsThis was an Italian retrospective study conducted among six dermatology referral centers. Patients ≥18 years affected by MF and in treatment with CL gel (160 µ/g), alone or in combination according to routine clinical practice, between December 2019 and December 2021 were considered. The study’s primary aim was to evaluate the effectiveness of CL gel in terms of overall response rate (ORR) after 3 months of treatment.ResultsA total of 79 patients (61% male) with different stages of MF (84% early stage) were included. CL gel was prescribed mainly in association with topical corticosteroids (66% of patients). ORR after 3 months of treatment was 42%, with no differences between early- and advanced-stage MF. Response rates improved over time up to 97% after 18 months of treatment. Overall, 66 AEs were reported in 67% of patients; most were hyperpigmentation (45%) and irritant contact dermatitis (37%). Six AEs led to treatment discontinuation, and five out of six (83%) patients who reported these events resumed treatment after interruption. No AEs were classified as severe.ConclusionsOur observations support the use of CL gel in patients with early- and advanced-stage MF, making it a valuable treatment option.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness and tolerability of chlormethine gel for the management of mycosis fungoides: a multicenter real-life evaluation

Alberti-Violetti,

Ardigò,

Massone

et al. 2024

Front. Oncol.

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“…This assumption is supported by the relatively swift and excellent response of the advanced stage MF, with which the patient presented in our lymphoma clinic, to the combination of nbUVB and acitretin. 1 This treatment combination is typically effective in early-stage disease but rarely in advanced-stage cases. Data considering the effect of cytokine-pathway blockers on the course of MF is scarce.…”

Section: Discussionmentioning

confidence: 99%

Cytokine-pathway blockers worsen mycosis fungoides masquerading as psoriasis

Blanchard,

Bisig,

de Leval

et al. 2024

JAAD Case Reports

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“…No additional imaging or testing is recommended, as no cases of distant or lymph node metastasis have been described in the localized form of pagetoid reticulosis ( 1 ). Radiotherapy or wide excision should be considered initially, as the cure rate is excellent and the recurrence rate is very low ( 1 , 5 ). Combined therapies and other modalities such as topical corticosteroids ( 1 ), photodynamic therapy ( 6 ), local chemotherapy (topical alkylating agents, interferon alpha-2b ( 7 ), imiquimod ( 8 )), or alitretinoin ( 9 ) may be used.…”

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confidence: 99%