Results of a prospective phase II trial with oral low-dose bexarotene plus photochemotherapy (PUVA) in refractory and/or relapsed patients with mycosis fungoides

Rupoli, Serena; Canafoglia, Lucia; Goteri, Gaia; Leoni, Pietro; Brandozzi, Giuliano; Federici, Irene; Micucci, Giorgia; Giantomassi, Federica; Mozzicafreddo, Giorgio; Alterini, Renato; Filosa, Giorgio; Ricotti, G.; Simonacci, Marco; Scortechini, Anna Rita; Zizzi, Antonio; Pimpinelli, Nicola

doi:10.1684/ejd.2015.2672

Cited by 15 publications

(10 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ORR was the most consistently reported clinical outcome and the highest ORR was reported in patients treated with conventional TSEB therapy (range: 50-95%) [56,78,79]. Of the pharmacological interventions, the highest ORR was observed following treatment with the approved therapy bexarotene (range: 39-86%) [48,76]. For the remaining pharmacological therapies, a very broad range of ORRs were reported (range: 14-78%) [55,62].…”

Section: Discussionmentioning

confidence: 98%

“…Where reported, all patients had recurrent or refractory disease following ≥1 therapy for CTCL prior to the therapy for which data were extracted. The majority of trials were single-arm investigations with patient cohorts ranging in size from 21 [47][48][49] to 216 [50] patients, with 30/58 studies enrolling ≤50 patients (publications meeting the inclusion criteria but reporting data on patient populations of <20 patients were excluded). Four of the studies included, including the two largest (N = 377 [51] and N = 372 [52]), were RCTs comparing CTCL therapies.…”

Section: Current Treatmentsmentioning

confidence: 99%

See 1 more Smart Citation

The clinical and humanistic burden of cutaneous T-cell lymphomas and response to conventional and novel therapies: results of a systematic review

Dalal

Mitchell

McCloskey

et al. 2020

Expert Review of Hematology

View full text Add to dashboard Cite

Objectives: To summarize the impact of relapsed/refractory primary cutaneous T-cell lymphomas (CTCL) on quality of life (QoL) and the efficacy of available treatments in two systematic reviews (SRs). Methods: Searches were performed on 16 January 2018 and 23 January 2018, respectively, in Medline, Medline in process, the Cochrane database, and EconLit. Studies reporting QoL outcomes in adults with CTCL or treatment efficacy in relapsed/refractory CTCL were included. Results: Based on 15 QoL studies, CTCL symptoms/complications negatively affect patients' physical, emotional, and social functioning. Skin problems pose considerable symptom burden, while advanced disease stage is associated with poorer QoL. CTCL negatively affects caregivers, primarily through family dynamics and relationships. The clinical efficacy SR included 72 publications covering 23 therapies. Overall response rate (ORR) ranged from 14% (belinostat) to 95% (total skin electron beam therapy). ORRs >50% were reported for several therapies including brentuximab vedotin (50-78%) and bexarotene (39-86%). Over half (13 of 23 therapies) had ORRs <30%. Median progression-free survival varied between treatments (3.5-116.4 months) and was >20 months for brentuximab vedotin and alemtuzumab. Conclusion: CTCL negatively affects patients' and caregivers' QoL. A considerable proportion of patients have no response or no sustainable response to current treatments.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Current Treatmentsmentioning

confidence: 99%

The clinical and humanistic burden of cutaneous T-cell lymphomas and response to conventional and novel therapies: results of a systematic review

Dalal

Mitchell

McCloskey

et al. 2020

Expert Review of Hematology

View full text Add to dashboard Cite

show abstract

“…As previous reports have suggested, the combination of bexarotene with psoralen and ultraviolet A (PUVA) therapy has been established for the treatment of early‐stage MF . Whittaker et al.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, more recently, Rupili et al. reported 21 cases of MF (including 15 cases of early‐stage MF), suggesting that bexarotene with PUVA therapy may prolong EFS and provide a low incident rate of SAE compared with historical control. Notably, Huang et al.…”

Section: Discussionmentioning

confidence: 99%

Case series of cutaneous T‐cell lymphomas treated with bexarotene‐based therapy

Fujimura

Sato

Tanita

et al. 2020

The Journal of Dermatology

View full text Add to dashboard Cite

Bexarotene is useful for both early and advanced cutaneous T-cell lymphoma (CTCL), and is sometimes applied to ultraviolet-tolerant early CTCL patients as one of the first-line therapies in the real world. However, continuous administration of bexarotene is sometimes difficult because of its adverse events (AE). Development of an appropriate protocol for bexarotene that can induce a consistent response for CTCL without severe AE (SAE) is needed. We retrospectively investigated 29 Japanese cases of CTCL and evaluated the efficacy of treatment and incident ratios of all AE and SAE. Objective response rate (ORR) for the overall cohort was 65.5%. ORR of the 300 mg/m 2 cohort (conventional dose) was 76.2%, while that of the 150-300 mg/body (low dose) with narrowband ultraviolet B light (NBUVB) cohort was 37.5%. Mean event-free survival was 10.0 months for all patients, 6.7 months for the bexarotene conventional-dose cohort and 19.1 months for the low-dose with NBUVB cohort. The incident ratio of total SAE for all patients was 20.7%. The incident ratio of total SAE was 23.8% for the conventional-dose cohort and 12.5% for the low-dose with NBUVB cohort. Our present study suggests that low-dose bexarotene plus NBUVB therapy is well-tolerated and could be one of the optimal therapies for advanced CTCL.

show abstract

“…44 In a small phase II prospective study, PUVA combined with low-dose bexarotene in refractory and/or resistant patients with early and advanced stage MF/SS achieved response rates up to 85% and a better tolerability profile than standard doses of bexarotene used in monotherapy. 46 Moreover, the combinations with retinoids may find a rationale in the reductions NMSCs risk.…”

Section: Timing and Indications For Combination Treatmentsmentioning

confidence: 99%

Standardization of regimens in Narrowband UVB and PUVA in early stage mycosis fungoides: position paper from the Italian Task Force for Cutaneous Lymphomas

Grandi

Fava

Rupoli

et al. 2018

Acad Dermatol Venereol

View full text Add to dashboard Cite

UV-based (PUVA and narrowband UVB) phototherapy is broadly and commonly used in the treatment of Cutaneous T-cell Lymphomas (CTCL), yet unfortunately, the evidence for the efficacy of these treatments is based only on case series or prospective but non-randomized studies. Therefore, no internationally approved guidelines exist and no standardization of schedules has been proposed. Recently, consensus guidelines have been published by the United States Cutaneous Lymphoma Consortium. The aim of this study was to review the biological and clinical evidences on PUVA and NB-UVB in CTCL and to critically evaluate acceptability and feasibility of these guidelines in the real-life setting from the perspective of the Cutaneous Lymphoma Task Force of the Italian Lymphoma Foundation (Fondazione Italiana Linfomi, FIL).

show abstract

Results of a prospective phase II trial with oral low-dose bexarotene plus photochemotherapy (PUVA) in refractory and/or relapsed patients with mycosis fungoides

Cited by 15 publications

References 18 publications

The clinical and humanistic burden of cutaneous T-cell lymphomas and response to conventional and novel therapies: results of a systematic review

The clinical and humanistic burden of cutaneous T-cell lymphomas and response to conventional and novel therapies: results of a systematic review

Case series of cutaneous T‐cell lymphomas treated with bexarotene‐based therapy

Standardization of regimens in Narrowband UVB and PUVA in early stage mycosis fungoides: position paper from the Italian Task Force for Cutaneous Lymphomas

Contact Info

Product

Resources

About