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Observational Study
. 2022 Mar;20(3):279-285.
doi: 10.1111/ddg.14657. Epub 2022 Jan 5.

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

Khaled Elsayad  1 , Daniel Rolf  1 , Cord Sunderkötter  2 , Carsten Weishaupt  3 , Elisa Christina Müller  1 , Tarek Nawar  1 , Rene Stranzenbach  4 , Elisabeth Livingstone  5 , Rudolf Stadler  6 , Kerstin Steinbrink  3 , Rose K C Moritz  2 , Hans Theodor Eich  1
Affiliations
Observational Study

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

Khaled Elsayad et al. J Dtsch Dermatol Ges. 2022 Mar.

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.

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References

    1. Elsayad K, Susek KH, Eich HT. Total skin electron beam therapy as part of multimodal treatment strategies for primary cutaneous T-cell lymphoma. Oncol Res Treat 2017; 40: 244-52.
    1. Nawar T, Elsayad K, Müller EC et al. Quality of life in mycosis fungoides and Sézary-syndrome patients undergoing low-dose total skin electron beam therapy with or without maintenance therapy. J Am Acad Dermatol 2021 Mar 17; S0190-9622(21)00564-8 [Online ahead of print].
    1. Hoppe RT, Harrison C, Tavallaee M et al. Low-dose total skin electron beam therapy as an effective modality to reduce disease burden in patients with mycosis fungoides: results of a pooled analysis from 3 phase-II clinical trials. J Am Acad Dermatol 2015; 72: 286-92.
    1. Kamstrup MR, Gniadecki R, Iversen L et al. Low-dose (10-Gy) total skin electron beam therapy for cutaneous T-cell lymphoma: an open clinical study and pooled data analysis. Int J Radiat Oncol Biol Phys 2015; 92: 138-43.
    1. Elsayad K, Kriz J, Moustakis C et al. Total skin electron beam for primary cutaneous T-cell lymphoma. Int J Radiat Oncol Biol Phys 2015; 93: 1077-86.

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