Low-dose total skin electron beam therapy plus oral bexarotene maintenance therapy for cutaneous T-cell lymphoma

J Dtsch Dermatol Ges. 2022 Mar;20(3):279-285. doi: 10.1111/ddg.14657. Epub 2022 Jan 5.

Abstract

Background: Total skin electron beam therapy (TSEBT) combined with systemic therapy or maintenance treatment is a reasonable approach to enhance the remission rate and duration in mycosis fungoides (MF) and Sézary syndrome (SS). This study assesses the efficacy of oral bexarotene therapy after low-dose TSEBT for patients with MF and SS.

Methods: In this prospective observational study, we recruited MF/SS patients for treatment with low-dose total skin electron beam therapy (TSEBT) with or without bexarotene therapy to describe outcomes and toxicities.

Results: Forty-six subjects with MF or SS underwent TSEBT between 2016 and 2021 at our institute. Following TSEBT, 27 patients (59 %) received oral bexarotene treatment. The median follow-up was 13 months. The overall response rate (ORR) for the cohort was 85 %. The response rate was significantly higher with combined modality (CM) than TSEBT alone (96 % vs. 68 %, p = 0.03). Median progression-free survival (PFS) for the CM was 17 months versus five months following TSEBT alone (p = 0.001). One patient (4 %) in the retinoid group discontinued the bexarotene therapy because of adverse events. The administration of bexarotene therapy did not increase radiation-related toxicities.

Conclusions: Response rate and progression-free survival might be improved with TSEBT in combination with oral bexarotene compared to TSEBT alone.

Publication types

  • Observational Study

MeSH terms

  • Bexarotene / therapeutic use
  • Electrons
  • Humans
  • Lymphoma, T-Cell, Cutaneous* / pathology
  • Mycosis Fungoides* / drug therapy
  • Mycosis Fungoides* / radiotherapy
  • Skin Neoplasms* / drug therapy
  • Skin Neoplasms* / pathology
  • Treatment Outcome

Substances

  • Bexarotene