Assaf Chalid, Waser Nathalie, Bagot Martine, He Mary, Li Tina, Dalal Mehul, Gavini Francois, Trinchese Fabrizio, Zomas Athanasios, Little Meredith, Pimpinelli Nicola, Ortiz-Romero Pablo L, Illidge Timothy M
Department of Dermatology, HELIOS Klinikum Krefeld, Academic Teaching Hospital of the University of Aachen, 47805 Krefeld, Germany.
Department of Dermatology, Charité-Universitätsmedizin, 10117 Berlin, Germany.
Cancers (Basel). 2021 Dec 29;14(1):145. doi: 10.3390/cancers14010145.
The treatment pattern of cutaneous T-cell lymphoma (CTCL) remains diverse and patient-tailored. The objective of this study was to describe the treatment patterns and outcomes in CTCL patients who were refractory or had relapsed (R/R) after a systemic therapy. A retrospective chart review study was conducted at 27 sites in France, Germany, Italy, Spain and the United Kingdom (UK) of patients who received a first course of systemic therapy and relapsed or were refractory. Data were collected longitudinally from diagnosis to first-, second- and third-line therapy. The study included 157 patients, with a median follow-up of 3.2 years. In total, 151 proceeded to second-line and 90 to third-line therapy. In the first line ( = 147), patients were treated with diverse therapies, including single- and multi-agent chemotherapy in 67 (46%), retinoids in 39 (27%), interferon in 31 (21%), ECP in 4 (3%), corticosteroids in 3 (2%) and new biological agents in 3 (2%). In the second line, the use of chemotherapy and retinoids remained similar to the first line, while the use of new biologics increased slightly. In sharp contrast to the first line, combination chemotherapy was extremely diverse. In the third line, the use of chemotherapy remained high and diverse as in the second line. From the time of first R/R, the median PFS was 1.2 years and the median OS was 11.5 years. The presented real-world data on the current treatments used in the management of R/R CTCL in Europe demonstrate the significant heterogeneity of systemic therapies and combination therapies, as expected from the European guidelines.
皮肤T细胞淋巴瘤(CTCL)的治疗模式仍然多种多样且需因人而异。本研究的目的是描述在接受全身治疗后难治或复发(R/R)的CTCL患者的治疗模式及结局。在法国、德国、意大利、西班牙和英国的27个地点开展了一项回顾性病历审查研究,纳入接受首个疗程全身治疗后复发或难治的患者。从诊断到一线、二线和三线治疗纵向收集数据。该研究纳入了157例患者,中位随访时间为3.2年。总计151例患者接受了二线治疗,90例接受了三线治疗。在一线治疗(n = 147)中,患者接受了多种治疗,包括单药和多药化疗67例(46%)、维甲酸39例(27%)、干扰素31例(21%)、体外光化学疗法(ECP)4例(3%)、皮质类固醇3例(2%)以及新型生物制剂3例(2%)。在二线治疗中,化疗和维甲酸的使用情况与一线治疗相似,而新型生物制剂的使用略有增加。与一线治疗形成鲜明对比的是,联合化疗极其多样。在三线治疗中,化疗的使用情况与二线治疗一样仍然居高不下且多样。从首次R/R时起,中位无进展生存期(PFS)为1.2年,中位总生存期(OS)为11.5年。欧洲关于R/R CTCL管理中当前使用治疗方法的这些真实世界数据表明,全身治疗和联合治疗存在显著异质性,正如欧洲指南所预期的那样。