Insights into treatment of patients with mycosis fungoides or Sézary syndrome using mogamulizumab.

PURPOSE

Mogamulizumab demonstrated improved outcomes vorinostat across a range of disease and patient characteristics in patients with mycosis fungoides or Sézary syndrome in the MAVORIC trial.

MATERIALS AND METHODS

This analysis further examined MAVORIC data to assess factors associated with long-term response (ORR >12 months), time to next treatment (TTNT), and impact of concomitant steroid use, lymphopenia, and mogamulizumab-associated rash (MAR) on patient response.

RESULTS

A higher proportion of patients achieved ORR lasting ≥4, 6, 8, or 12 months in the mogamulizumab vorinostat arm. Long-term response was also observed in mogamulizumab-treated patients with more advanced disease (stage IVA1 [17/20], B2 blood involvement [18/20], and SS [14/20]). PFS was significantly longer (9.4 3.1 months;  < 0.0001) in mogamulizumab vorinostat-treated patients taking concomitant steroids. Mogamulizumab-treated patients experienced longer TTNT vorinostat. Lymphopenia and MAR were associated with response to mogamulizumab.

CONCLUSIONS

MAVORIC demonstrated greater efficacy with mogamulizumab vorinostat in relapsed/refractory patients with CTCL, including those with more advanced disease. Concomitant steroid use improved ORR and PFS but did not impact vorinostat outcomes. Overall responses occurred more frequently in mogamulizumab-treated patients that developed lymphopenia than those that did not. A higher percentage of patients with MAR had an overall response than those without MAR.