The efficacy and safety of methotrexate versus interferon in cutaneous T-cell lymphomas

Wain, Thevaki; Pavli, Alexandra; Wells, Jillian; Fernández‐Peñas, Pablo

doi:10.1080/09546634.2018.1441492

Cited by 4 publications

(13 citation statements)

References 24 publications

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“…Interestingly, the TTR was significantly shorter in the IFN-α group than in the MTX group (1 month vs. 2 months). Responses to both IFN-α and MTX were achieved 1 month earlier compared to the results published by Wain et al [9]. The reasons for differences in TTR and RR between our trial and the Wain et al study are unclear [9].…”

Section: Discussioncontrasting

confidence: 40%

“…The major side effects of IFN-α treatment are dose-dependent and include flu-like symptoms, elevated transaminases, myelosuppression, and depression. INF-α has proven to be effective in MF and SS treatment, both as monotherapy and in combination with oral retinoids, bexarotene, or PUVA therapy [4][5][6][7][8][9][10][11][12]. The few studies assessing the use of IFN-α monotherapy in CTCL demonstrated that partial response was achieved in 25% to 49% of patients [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…The few studies assessing the use of IFN-α monotherapy in CTCL demonstrated that partial response was achieved in 25% to 49% of patients [10][11][12]. A recent retrospective study by Wain et al demonstrated that IFN-α therapy was associated with a better response and a shorter time to response (TTR) compared with MTX in MF patients [9].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy, quality of life, and safety of methotrexate versus interferon in head-to-head treatment in advanced stages of mycosis fungoides and Sezary syndrome. Prospective trial (NCT02323659)

Chmielowska¹,

Sokołowska‐Wojdyło²,

Olszewska³

et al. 2021

pdia

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Introduction: ESMO guidelines recommend interferon (IFN) and methotrexate (MTX) as first-line systemic therapies in mycosis fungoides (MF) and Sezary syndrome (SS). Aim: A prospective, head-to-head trial comparing the efficacy and safety of INF-α and MTX as first-line treatment in MF/SS patients. Material and methods: Forty-three patients were enrolled in the trial. The response to treatment and side effects were assessed. Study variables included mSWAT, DLQI, and VAS scores. Results: The response rate in stage IV including SS was significantly higher in the IFN-α group than in the MTX group (100% vs. 40%; p = 0.03, respectively). No significant differences were found in response rate in stage IIB and III between treatment groups. Patients treated with IFN-α had significantly shorter time to achieve response (TTR). Significantly fewer in the IFN-α group experienced adverse events (AE) in comparison to patients treated with MTX (81% vs. 45%; p = 0.02). There was no statistically significant difference between both groups in terms of time to progression (TTP), progression-free survival (PFS), time on treatment (ToT), and time to next treatment (TTNT). The improvement in quality of life and reduction of pruritus was comparable in both treatment groups. Conclusions: The obtained data suggest that the efficacy of IFN-α as first-line treatment in advanced stage (IV) MF and SS is significantly better than MTX. IFN-α presented significantly better safety and tolerability and shorter TTR than MTX. However, the results should be interpreted with caution due to scarce study groups.

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Section: Discussioncontrasting

confidence: 40%

Section: Introductionmentioning

confidence: 99%

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Efficacy, quality of life, and safety of methotrexate versus interferon in head-to-head treatment in advanced stages of mycosis fungoides and Sezary syndrome. Prospective trial (NCT02323659)

Chmielowska¹,

Sokołowska‐Wojdyło²,

Olszewska³

et al. 2021

pdia

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“…Low‐dosed methotrexate (MTX; 5 to 25 mg/week) is recommended for stage IIB or higher. It may be used as monotherapy or combined with bexarotene or IFNα2b [ 82 , 94 ]. Intravenous chemotherapy, as monochemotherapy with pegylated liposomal doxorubicine or gemcitabine, is recommended for patients in the tumor stage with visceral involvement, for treatment of refractory/recurrent disease, or for “debulking” (reduction of tumor burden, a priori).…”

Section: Systemic Treatmentmentioning

confidence: 99%

Mycosis fungoides and Sézary syndrome

Jonak

Tittes

Brunner

et al. 2021

J Deutsche Derma Gesell

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Mycosis fungoides (MF) and Sézary syndrome (SS) are primary cutaneous T-cell lymphomas (CTCL) with not yet fully understood etiology and pathogenesis. Conceptually, MF and SS are classified as distinct entities arising from different T helper cell subsets. MF is the most common CTCL entity, while SS is very rare. MF presents clinically with patch, plaque and/or tumor stages, but can also evolve as erythroderma, which in turn is pathognomonic for SS. SS is characterized by a detectable tumor-cell burden (Sézary cells) in the peripheral blood consistent with advanced-stage disease and a poor prognosis. In early-stage disease of MF, which is the predominant form, the prognosis is generally favorable. However, in up to 30 % of patients, there is progression of skin lesions, which can ultimately lead to visceral involvement. The histological manifestation of MF can be subtle in early-stage disease and therefore a careful clinicopathological correlation is paramount. The treatment of MF/SS is dependent on the disease stage. Therapeutic options include both skin-directed and systemic regimens. Apart from allogeneic stem cell transplantation (alloSCT), there is as yet no curative therapy for MF/SS. Accordingly, the treatment approach is symptom oriented and aims to reduce the tumor burden and improve health-related quality of life. However, the therapeutic landscape for CTCL is constantly being expanded by the discovery of novel therapeutic targets.

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“…Deshalb wird eine Kombination von IFNα2b mit Retinoid für Patienten bei unzureichendem Therapieerfolg in der Monotherapie empfohlen oder wenn eine Kombination mit PUVA kontraindiziert oder nicht verfügbar ist[82]. Niedrig dosiertes Methotrexat (MTX; 5 25 mg/Woche) wird ab IIB empfohlen und kann als Mono-oder Kombinationstherapie mit Bexaroten oder IFNα2b verabreicht werden[82,94]. Eine intravenöse Chemotherapie wird bei Patienten im Tumorstadium, mit viszeraler Beteiligung, bei therapierefraktärerer/rezidivierender Erkrankung oder für Debulking (Tumorlastreduktion, a priori) als Monochemotherapie mit pegyliertem liposomalen Doxorubicin oder Gemcitabin empfohlen.…”

unclassified

Mycosis fungoides und Sézary‐Syndrom

Jonak

Tittes

Brunner

et al. 2021

J Deutsche Derma Gesell

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Die Mycosis fungoides (MF) und das Sézary-Syndrom (SS) sind primär kutane T-Zell-Lymphome (CTCL), deren Ätiologie und Pathogenese noch nicht vollständig geklärt sind. MF und SS werden konzeptionell als eigenständige Entitäten angesehen, mit unterschiedlichen T-Helferzell-Subtypen als Ursprung. Während die MF den häufigsten Subtyp der CTCL darstellt, ist das SS hingegen sehr selten. Klinisch werden bei der MF das Patch-, Plaque-und Tumor-Stadium unterschieden, wobei sich auch eine Erythrodermie manifestieren kann, welche wiederum pathognomonisch für das SS ist. Das SS ist durch eine Leukämie und/oder eine nachweisbare Tumorzelllast (Sézary-Zellen) im peripheren Blut gekennzeichnet und per se ein fortgeschrittenes Krankheitsstadium mit ungünstiger Prognose. Bei der MF ist die Prognose im frühen Krankheitsstadium, der überwiegenden Verlaufsform, vorteilhaft. Bei bis zu 30 % der Patienten ist jedoch ein Fortschreiten der kutanen Erkrankung bis hin zu extrakutanen Manifestationen dokumentiert. Die histologischen Veränderungen der MF sind im Frühstadium oft diskret und daher ist eine sorgfältige klinisch-pathologische Korrelation essenziell. Die Behandlung von MF und SS erfolgt stadiengerecht mit topischen und/oder systemischen Therapieschemata. Abseits der allogenen Stammzelltransplantation (alloSZT) gibt es bisher keine kurative Therapie für MF/SS. Dementsprechend ist der Behandlungsansatz symptomorientiert und zielt auf eine Tumorlastreduktion und eine Verbesserung der gesundheitsbezogenen Lebensqualität ab. Die aktuelle Therapielandschaft für CTCL wird permanent durch die Entdeckung neuer therapeutischer Zielstrukturen erweitert.

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The efficacy and safety of methotrexate versus interferon in cutaneous T-cell lymphomas

Cited by 4 publications

References 24 publications

Efficacy, quality of life, and safety of methotrexate versus interferon in head-to-head treatment in advanced stages of mycosis fungoides and Sezary syndrome. Prospective trial (NCT02323659)

Efficacy, quality of life, and safety of methotrexate versus interferon in head-to-head treatment in advanced stages of mycosis fungoides and Sezary syndrome. Prospective trial (NCT02323659)

Mycosis fungoides and Sézary syndrome

Mycosis fungoides und Sézary‐Syndrom

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