Use of Pegylated Interferon Alpha-2a in Cutaneous T-cell Lymphoma: A Retrospective Case Collection
DOI:
https://doi.org/10.2340/actadv.v103.10306Keywords:
mycosis fungoides, pegylated interferon, Sézary syndromeAbstract
Mycosis fungoides and Sézary syndrome are rare and largely incurable types of cutaneous T-cell lymphoma with limited therapeutic options. In 1984 Bunn et al. reported that interferon alpha is an efficient monotherapy in cutaneous T-cell lymphoma and 14 years later it was shown in a prospective, randomized trial that a combination of interferon alpha and psoralen plus ultraviolet A therapy (PUVA) is most efficient in the treatment of cutaneous T-cell lymphoma. Since then interferon alpha as single agent or, most often, in combination with phototherapy and/or retinoids has been integrated as standard of care in cutaneous T-cell lymphoma guidelines worldwide. However, production of interferon alpha was discontinued recently worldwide and pegylated interferon alpha-2a (PEG-IFNα) has been used as an alternative therapy. In contrast to numerous interferon alpha studies, only a few studies focusing on PEG-IFNα are available. Therefore, the aim of this study was to conduct a retrospective data collection to report on the efficacy, adverse events and therapy regimens of PEG-IFNα in cutaneous T-cell lymphoma. In 28 patients with cutaneous T-cell lymphoma treated in Germany and in the Netherlands, 36% of patients achieved complete remission, 36% partial remission and 29% stable disease. Eighteen percent of patients developed adverse events during therapy, which led to the discontinuation of PEG-IFNα therapy in 2 patients. The most common concomittant therapies were oral PUVA phototherapy and local radiotherapy. In conclusion, PEG-IFNα, especially in combination with skin-directed therapies, is an effective treatment option for cutaneous T-cell lymphoma in clinical practice.
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Jawed SI, Myskowski PL, Horwitz S, Moskowitz A, Querfeld C. Primary cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome): part II. Prognosis, management, and future directions. J Am Acad Dermatol 2014; 70: 240-242. DOI: https://doi.org/10.1016/j.jaad.2013.08.033
https://doi.org/10.1016/j.jaad.2013.07.049 DOI: https://doi.org/10.1016/j.jaad.2013.07.049
Bunn PA Jr, Foon KA, Ihde DC, Longo DL, Eddy J, Winkler CF, , et al. Recombinant leukocyte A interferon: an active agent in advanced cutaneous T-cell lymphomas. Ann Intern Med 1984; 101:484-487.
https://doi.org/10.7326/0003-4819-101-4-484 DOI: https://doi.org/10.7326/0003-4819-101-4-484
Trautinger F, Eder J, Assaf C, Bagot M, Cozzio A, Dummer R, et al. European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome - Update 2017. Eur J Cancer 2017; 77: 57-74.
https://doi.org/10.1016/j.ejca.2017.02.027 DOI: https://doi.org/10.1016/j.ejca.2017.02.027
Willemze R, Hodak E, Zinzani PL, Specht L, Ladetto M; ESMO Guidelines Committee. Primary cutaneous lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29: iv30-iv40.
https://doi.org/10.1093/annonc/mdy133 DOI: https://doi.org/10.1093/annonc/mdy133
Gilson D, Whittaker SJ, Child FJ, Scarisbrick JJ, Illidge TM, Parry EJ, et al. British Association of Dermatologists and U.K. Cutaneous Lymphoma Group guidelines for the management of primary cutaneous lymphomas 2018. Br J Dermatol 2019; 180: 496-526.
https://doi.org/10.1111/bjd.17240 DOI: https://doi.org/10.1111/bjd.17240
Dippel E, Assaf C, Becker JC, von Bergwelt-Baildon M, Bernreiter S, Cozzio A, et al. S2k guideline - Cutaneous lymphomas (ICD10 C82-C86): update 2021. J Dtsch Dermatol Ges 2022; 20: 537-555. DOI: https://doi.org/10.1111/ddg.14706_g
https://doi.org/10.1111/ddg.14706 DOI: https://doi.org/10.1111/ddg.14706
Spaccarelli N, Rook AH. The use of interferons in the treatment of cutaneous T-cell lymphoma. Dermatol Clin 2015; 33: 731-745.
https://doi.org/10.1016/j.det.2015.05.008 DOI: https://doi.org/10.1016/j.det.2015.05.008
Harris JM, Martin NE, Modi M. Pegylation: a novel process for modifying pharmacokinetics. Clin Pharmacokinet 2001; 40:539-551.
https://doi.org/10.2165/00003088-200140070-00005 DOI: https://doi.org/10.2165/00003088-200140070-00005
Schiller M, Tsianakas A, Sterry W, Dummer R, Hinke A, Nashan D, et al. Dose-escalation study evaluating pegylated interferon alpha-2a in patients with cutaneous T-cell lymphoma. J Eur Acad Dermatol Venereol 2017; 31: 1841-1847.
https://doi.org/10.1111/jdv.14366 DOI: https://doi.org/10.1111/jdv.14366
EMA Pegasys product information. Last updated November 11, 2022. [accessed 2023 Feb 26]. Available from: https://www.ema.europa.eu/en/documents/product-information/pegasys-epar-product-information_de.pdf.
Olsen EA, Whittaker S, Willemze R, Pinter-Brown L, Foss F, Geskin L, et al. Primary cutaneous lymphoma: recommendations for clinical trial design and staging update from the ISCL, USCLC, and EORTC. Blood 2022; 140: 419-437.
https://doi.org/10.1182/blood.2021012057 DOI: https://doi.org/10.1182/blood.2021012057
Mitsunaga K, Bagot M, Beylot-Barry M, Ram-Wolff C. Real-world study of the use of pegylated interferon alfa for treatment of primary cutaneous T-cell lymphomas: an EORTC CLTF study. Eur J Cancer 2022; 173S1: S1-S58.
https://doi.org/10.1016/S0959-8049(22)00599-8 DOI: https://doi.org/10.1016/S0959-8049(22)00599-8
Patsatsi A, Papadavid E, Kyriakou A, Georgiou E, Koletsa T, Avgeros C, et al. The use of pegylated interferon a-2a in a cohort of Greek patients with mycosis fungoides. J Eur Acad Dermatol Venereol 2022; 36: e291-e293.
https://doi.org/10.1111/jdv.17795 DOI: https://doi.org/10.1111/jdv.17795
Stadler R, Otte HG, Luger T, Henz BM, Kühl P, Zwingers T, et al. Prospective randomized multicenter clinical trial on the use of interferon -2a plus acitretin versus interferon -2a plus PUVA in patients with cutaneous T-cell lymphoma stages I and II. Blood 1998; 92: 3578-3581.
Chiarion-Sileni V, Bononi A, Fornasa CV, Soraru M, Alaibac M, Ferrazzi E, et al. Phase II trial of interferon-alpha-2a plus psolaren with ultraviolet light A in patients with cutaneous T-cell lymphoma. Cancer 2002; 95: 569-575.
https://doi.org/10.1002/cncr.10706 DOI: https://doi.org/10.1002/cncr.10706
Quaglino P, Maule M, Prince HM, Porcu P, Horwitz S, Duvic M, et al. Global patterns of care in advanced stage mycosis fungoides/Sezary syndrome: a multicenter retrospective follow-up study from the Cutaneous Lymphoma International Consortium. Ann Oncol 2017; 28: 2517-2525.
https://doi.org/10.1093/annonc/mdx352 DOI: https://doi.org/10.1093/annonc/mdx352
Barbui T, Tefferi A, Vannucchi AM, Passamonti F, Silver RT, Hoffman R, et al. Philadelphia chromosome-negative classical myeloproliferative neoplasms: revised management recommendations from European LeukemiaNet. Leukemia 2018; 32: 1057-1069.
https://doi.org/10.1038/s41375-018-0077-1 DOI: https://doi.org/10.1038/s41375-018-0077-1
Yacoub A, Mascarenhas J, Kosiorek H, Prchal JT, Berenzon D, Baer MR, et al. Pegylated interferon alfa-2a for polycythemia vera or essential thrombocythemia resistant or intolerant to hydroxyurea. Blood 2019; 134: 1498-1509.
https://doi.org/10.1182/blood.2019000428 DOI: https://doi.org/10.1182/blood.2019000428
Halfon P, Pérusat S, Bourlière M, Bronowicki JP, Trimoulet P, Benhamou Y, et al. ANRS HC16 GAMMATRI Study Group. Neutralizing antibodies to interferon-α and circulating interferon in patients with chronic hepatitis C non-responding to pegylated interferon plus ribavirin re-treated by pegylated interferon-α-2a and ribavirin (ANRS HC16 GAMMATRI substudy). J Med Virol 2010; 82: 2027-2031.
https://doi.org/10.1002/jmv.21909 DOI: https://doi.org/10.1002/jmv.21909
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