Zusammenfassung
Primär kutane T‑Zell-Lymphome sind eine heterogene Gruppe von seltenen Erkrankungen. Die Patienten leiden häufig an stark juckenden Hautveränderungen, Sichtbarkeit der Läsionen, Infektionen, Rezidiven, und ihre Lebenserwartung kann reduziert sein. Unter den aktuellen Therapien sind dauerhafte komplette Remissionen selten. Neue Therapieansätze und Kombinationstherapien ändern jedoch den Horizont. Hier geben wir einen Überblick zu diesem Thema.
Abstract
Primary cutaneous T‑cell lymphomas are a heterogeneous group of rare diseases. Patients often suffer from visible, severely pruritic skin lesions, infections, relapses, and their life expectancy may be reduced. Under current therapies, long-lasting, complete remission is rare. However, new treatment approaches and combination therapies are changing the future. Here, we provide an overview on this topic.
Literatur
Verwendete Literatur
Assaf C, Dobos G, Zech IM, Doess A, Hibbe T, Jadasz JJ (2022) Versorgungsstruktur der Patienten mit Mycosis fungoides und Sézary-Syndrom in Deutschland - Versorgungsforschung auf Basis von GKV-Routinedaten. J Dtsch Dermatol Ges 20(5):643–652
Assaf C, Booken N, Dippel E, Guenova E, Jonak C, Klemke CD, Nicolay JP, Schlaak M, Wobser M, Trautinger F (2022) Chlormethin-Gel zur Behandlung der Mycosis fungoides: Ein Expertenkonsens aus Deutschland, Österreich und der Schweiz (DACH-Region) zum Therapiemanagement. J Dtsch Dermatol Ges 20(5):579–588
Assaf C, Waser N, Bagot M, He M, Li T, Dalal M, Gavini F, Trinchese F, Zomas A, Little M, Pimpinelli N, Ortiz-Romero PL, Illidge TM (2021) Contemporary treatment patterns and response in relapsed/refractory cutaneous T‑cell lymphoma (CTCL) across five European countries. Cancers (Basel) 14(1):145
Bagot M, Porcu P, Marie-Cardine A, Battistella M, William BM, Vermeer M et al (2019) IPH4102, a first-in-class anti-KIR3DL2 monoclonal antibody, in patients with relapsed or refractory cutaneous T‑cell lymphoma: an international, first-in-human, open-label, phase 1 trial. Lancet Oncol 20(8):1160–1170
Bagot M, Dalle S, Sokol L, Tsianakas A, Musiek A, Ortiz-Romero PL, Poligone B, Duvic M, Elmets C, Leoni M, Dwyer K, Ito T, Herr F, Kim YH (2022) Long-term disease control and safety with the anti-CCR4 antibody mogamulizumab: post-hoc analyses from the MAVORIC trial of patients with previously treated cutaneous T‑cell lymphoma. Dermatol Ther 8:e15634. https://doi.org/10.1111/dth.15634
Beylot-Barry M, Booken N, Weishaupt C, Medley M, Sun W, Rosen JP (2021) Efficacy of mogamulizumab in mycosis fungoides by patient blood involvement and time to response analysis in mycosis fungoides and Sézary syndrome: a post hoc analysis of the MAVORIC study. Eur J Cancer 156(Suppl 1):S47–S48. https://doi.org/10.1016/S0959-8049(21)00714-0
Blazejak C, Stranzenbach R, Gosman J, Gambichler T, Wehkamp U, Stendel S, Klemke CD, Wobser M, Olk J, Nicolay JP, Weyermann M, Stadler R, Assaf C (2022) Clinical outcomes of advanced-stage cutaneous lymphoma under low-dose gemcitabine treatment: real-life data from the German Cutaneous Lymphoma Network. Dermatology 238(3):498–506
Cheng M, Zain J, Rosen ST, Querfeld C (2022) Emerging drugs for the treatment of cutaneous T‑cell lymphoma. Expert Opin Emerg Drugs 27(1):45–54. https://doi.org/10.1080/14728214.2022.2049233
Dippel E, Assaf C, Becker JC, von Bergwelt-Baildon M, Bernreiter S, Cozzio A, Eich HT, Elsayad K, Follmann M, Grabbe S, Hillen U, Klapper W, Klemke CD, Loquai C, Meiss F, Mitteldorf C, Wehkamp U, Nashan D, Nicolay JP, Oschlies I, Schlaak M, Stranzenbach R, Moritz R, Stoll C, Vag T, Weichenthal M, Wobser M, Stadler R (2022) S2k-Leitlinie – Kutane Lymphome (ICD10 C82–C86): Update 2021. J Dtsch Dermatol Ges 20(4):537–555. https://doi.org/10.1111/ddg.14706_g
Dobos G, de Masson A, Ram-Wolff C, Beylot-Barry M, Pham-Ledard A, Ortonne N et al (2021) Epidemiological changes in cutaneous lymphomas: an analysis of 8593 patients from the French Cutaneous Lymphoma Registry. Br J Dermatol 184(6):1059–1067. https://doi.org/10.1111/bjd.19644
Dobos G, Pohrt A, Ram-Wolff C, Lebbé C, Bouaziz JD, Battistella M, Bagot M, de Masson A (2020) Epidemiology of cutaneous T‑cell lymphomas: a systematic review and meta-analysis of 16,953 patients. Cancers (Basel) 12(10):2921. https://doi.org/10.3390/cancers12102921
García-Díaz N, Piris MÁ, Ortiz-Romero PL, Vaqué JP (2021) Mycosis fungoides and Sézary syndrome: an integrative review of the pathophysiology, molecular drivers, and targeted therapy. Cancers (Basel) 13(8):1931. https://doi.org/10.3390/cancers13081931
Georgakopoulos I, Papadavid E, Platoni K, Kougioumtzopoulou A, Patatoukas G, Kypraiou E, Nikolaou V, Efstathopoulos E, Kelekis N, Kouloulias V (2020) Low dose total skin electron beam therapy for the management of T cell cutaneous lymphomas. Dermatol Ther 33(4):e13478. https://doi.org/10.1111/dth.13478
Hughes CF, Khot A, McCormack C, Lade S, Westerman DA, Twigger R, Buelens O, Newland K, Tam C, Dickinson M, Ryan G, Ritchie D, Wood C, Prince HM (2015) Lack of durable disease control with chemotherapy for mycosis fungoides and Sézary syndrome: a comparative study of systemic therapy. Blood 125(1):71–81. https://doi.org/10.1182/blood-2014-07-588236
Mehta-Shah N, Horwitz SM, Ansell S, Ai WZ, Barnes J, Barta SK, Clemens MW, Dogan A, Fisher K, Goodman AM, Goyal G, Guitart J, Halwani A, Haverkos BM, Hoppe RT, Jacobsen E, Jagadeesh D, Lunning MA, Mehta A, Olsen EA, Pro B, Rajguru SA, Shanbhag S, Shaver A, Shustov A, Sokol L, Torka P, Torres-Cabala C, Wilcox R, William BM, Zain J, Dwyer MA, Sundar H, Kim YH (2020) NCCN guidelines insights: primary cutaneous lymphomas, version 2.2020. J Natl Compr Canc Netw 18(5):522–536. https://doi.org/10.6004/jnccn.2020.0022
Mourad A, Gniadecki R (2020) Overall survival in mycosis fungoides: a systematic review and meta-analysis. J Invest Dermatol 140(2):495–497.e5. https://doi.org/10.1016/j.jid.2019.07.712
Nicolay JP, Albrecht JD, Alberti-Violetti S, Berti E (2021) CCR4 in cutaneous T‑cell lymphoma: therapeutic targeting of a pathogenic driver. Eur J Immunol 51(7):1660–1671
Ottevanger R, van Beugen S, Evers AWM, Willemze R, Vermeer MH, Quint KD (2021) Quality of life in patients with mycosis fungoides and Sézary syndrome: a systematic review of the literature. J Eur Acad Dermatol Venereol 35(12):2377–2387. https://doi.org/10.1111/jdv.17570
Prince HM, Kim YH, Horwitz SM, Dummer R, Scarisbrick J, Quaglino P, Zinzani PL, Wolter P, Sanches JA, Ortiz-Romero PL, Akilov OE, Geskin L, Trotman J, Taylor K, Dalle S, Weichenthal M, Walewski J, Fisher D, Dréno B, Stadler R, Feldman T, Kuzel TM, Wang Y, Palanca-Wessels MC, Zagadailov E, Trepicchio WL, Zhang W, Lin HM, Liu Y, Huebner D, Little M, Whittaker S, Duvic M, ALCANZA study group (2017) Brentuximab vedotin or physician’s choice in CD30-positive cutaneous T‑cell lymphoma (ALCANZA): an international, open-label, randomised, phase 3, multicentre trial. Lancet 390(10094):555–566. https://doi.org/10.1016/S0140-6736(17)31266-7
Rook AH, Gelfand JM, Wysocka M, Troxel AB, Benoit B, Surber C, Elenitsas R, Buchanan MA, Leahy DS, Watanabe R, Kirsch IR, Kim EJ, Clark RA (2015) Topical resiquimod can induce disease regression and enhance T‑cell effector functions in cutaneous T‑cell lymphoma. Blood 126(12):1452–1461
Scarisbrick JJ, Prince HM, Vermeer MH, Quaglino P, Horwitz S, Porcu P, Stadler R, Wood GS, Beylot-Barry M, Pham-Ledard A, Foss F, Girardi M, Bagot M, Michel L, Battistella M, Guitart J, Kuzel TM, Martinez-Escala ME, Estrach T, Papadavid E, Antoniou C, Rigopoulos D, Nikolaou V, Sugaya M, Miyagaki T, Gniadecki R, Sanches JA, Cury-Martins J, Miyashiro D, Servitje O, Muniesa C, Berti E, Onida F, Corti L, Hodak E, Amitay-Laish I, Ortiz-Romero PL, Rodríguez-Peralto JL, Knobler R, Porkert S, Bauer W, Pimpinelli N, Grandi V, Cowan R, Rook A, Kim E, Pileri A, Patrizi A, Pujol RM, Wong H, Tyler K, Stranzenbach R, Querfeld C, Fava P, Maule M, Willemze R, Evison F, Morris S, Twigger R, Talpur R, Kim J, Ognibene G, Li S, Tavallaee M, Hoppe RT, Duvic M, Whittaker SJ, Kim YH (2015) Cutaneous Lymphoma International Consortium study of outcome in advanced stages of mycosis fungoides and Sézary syndrome: effect of specific prognostic markers on survival and development of a prognostic model. J Clin Oncol 33(32):3766–3773. https://doi.org/10.1200/JCO.2015.61.7142
Stadler R, Scarisbrick JJ (2021) Maintenance therapy in patients with mycosis fungoides or Sézary syndrome: a neglected topic. Eur J Cancer 142:38–47. https://doi.org/10.1016/j.ejca.2020.10.007
Stadler R, Otte HG, Luger T, Henz BM, Kühl P, Zwingers T, Sterry W (1998) 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 92(10):3578–3581
Trautinger F, Eder J, Assaf C, Bagot M, Cozzio A, Dummer R, Gniadecki R, Klemke CD, Ortiz-Romero PL, Papadavid E, Pimpinelli N, Quaglino P, Ranki A, Scarisbrick J, Stadler R, Väkevä L, Vermeer MH, Whittaker S, Willemze R, Knobler R (2017) European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome—update 2017. Eur J Cancer 77:57–74. https://doi.org/10.1016/j.ejca.2017.02.027
Willemze R, Cerroni L, Kempf W, Berti E, Facchetti F, Swerdlow SH et al (2019) The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas. Blood 133(16):1703–1714
Willemze R, Hodak E, Zinzani PL, Specht L, Ladetto M, ESMO Guidelines Committee (2018) Primary cutaneous lymphomas: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 29(Suppl 4):iv30–iv40. https://doi.org/10.1093/annonc/mdy133
Weiterführende Literatur
Bagot M, Porcu P, Marie-Cardine A, Battistella M, William BM, Vermeer M, Whittaker S, Rotolo F, Ram-Wolff C, Khodadoust MS, Bensussan A, Paturel C, Bonnafous C, Sicard H, Azim HA Jr, Kim YH (2019) IPH4102, a first-in-class anti-KIR3DL2 monoclonal antibody, in patients with relapsed or refractory cutaneous T‑cell lymphoma: an international, first-in-human, open-label, phase 1 trial. Lancet Oncol 20(8):1160–1170. https://doi.org/10.1016/S1470-2045(19)30320-1
Olsen EA, Whittaker S, Willemze R, Pinter-Brown L, Foss FM, Geskin LJ et al (2022) Primary cutaneous lymphoma: recommendations for clinical trial design and staging update from the ISCL, USCLC, and EORTC. Blood 140(5):419–437
Scarisbrick JJ, Hodak E, Bagot M, Stranzenbach R, Stadler R, Ortiz-Romero PL et al (2018) Blood classification and blood response criteria in mycosis fungoides and Sezary syndrome using flow cytometry: recommendations from the EORTC cutaneous lymphoma task force. Eur J Cancer 93:47–56
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
C. Assaf erhielt Honoraria von Kyowa Kirin, Recordati, Helsinn, Takeda und 4SC. G. Dobos erhielt Honoraria von Kyowa Kirin, Recordati und Helsinn.
Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
Additional information
QR-Code scannen & Beitrag online lesen
Rights and permissions
About this article
Cite this article
Assaf, C., Dobos, G. Neue Therapieansätze und Kombinationstherapien bei kutanen T-Zell-Lymphomen. Dermatologie 73, 782–787 (2022). https://doi.org/10.1007/s00105-022-05053-x
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00105-022-05053-x