Department of Dermatology, University of Texas Southwestern, Dallas, TX, USA.
Int J Dermatol. 2017 Dec;56(12):1400-1405. doi: 10.1111/ijd.13696. Epub 2017 Aug 1.
The utility of brentuximab vedotin (BV) in CD30 systemic lymphomas is established, however evidence for treating primary cutaneous lymphoma remains limited. This study aimed to evaluate BV in treating CD30 transformed mycosis fungoides (MF) and primary cutaneous anaplastic large cell lymphoma (PC-ALCL).
A literature review was conducted, and we analyzed data from published trials and case reports obtained via search of Ovid-MEDLINE and PubMed databases. The search yielded 372 reports, and 10 publications met inclusion criteria. Sixty-one patients with CD30 transformed MF and seven with PC-ALCL were included.
Mean age at BV initiation was 60.8 years (67 - PC-ALCL; 60.1 - MF), and 4.1 therapies were attempted prior to BV (3.1 - PC-ALCL; 4.2 - MF). The overall response rate was 67.7% (100% - PC-ALCL; 63.9% - MF), with 16.2% of patients experiencing complete response (100% - PC-ALCL; 6.6% - MF). Mean time to clinical response was 5.3 and 9.3 weeks for PC-ALCL and MF, respectively. Mean response duration for patients with PC-ALCL was 7.6 and 7.8 months for MF. Peripheral neuropathy (57.2%) and fatigue (35.6%) were the most commonly reported adverse effects.
This analysis summates the current evidence regarding the use of BV in treating CD30 MF and PC-ALCL. Preliminary results indicate that BV is effective for CD30 CTCL, however additional studies with larger sample sizes are necessary. The study provides clinicians with the clinical context in which BV may be appropriate as well as information regarding therapeutic expectations and outcomes.
博纳吐单抗贝林妥欧单抗（BV）在 CD30 系统性淋巴瘤中的应用已得到证实，然而，治疗原发性皮肤淋巴瘤的证据仍然有限。本研究旨在评估 BV 治疗 CD30 转化蕈样肉芽肿（MF）和原发性皮肤间变性大细胞淋巴瘤（PC-ALCL）的疗效。
进行了文献回顾，并通过在 Ovid-MEDLINE 和 PubMed 数据库中搜索，分析了已发表试验和病例报告的数据。搜索共得到 372 篇报告，其中 10 篇符合纳入标准。纳入了 61 例 CD30 转化 MF 患者和 7 例 PC-ALCL 患者。
BV 起始时的平均年龄为 60.8 岁（PC-ALCL 为 67 岁；MF 为 60.1 岁），在接受 BV 治疗前尝试了 4.1 种疗法（PC-ALCL 为 3.1 种；MF 为 4.2 种）。总体缓解率为 67.7%（PC-ALCL 为 100%；MF 为 63.9%），16.2%的患者达到完全缓解（PC-ALCL 为 100%；MF 为 6.6%）。PC-ALCL 和 MF 的临床缓解中位时间分别为 5.3 周和 9.3 周。PC-ALCL 患者的缓解持续时间中位值为 7.6 个月，MF 为 7.8 个月。最常见的不良反应是周围神经病（57.2%）和疲劳（35.6%）。
本分析总结了目前关于 BV 治疗 CD30 MF 和 PC-ALCL 的证据。初步结果表明，BV 对 CD30 CTCL 有效，但需要更大样本量的进一步研究。该研究为临床医生提供了关于 BV 应用的临床背景信息，以及关于治疗期望和结果的信息。
