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

Khaled Elsayad, Daniel Rolf, Cord Sunderkötter, Carsten Weishaupt, Elisa Christina Müller, Tarek Nawar, Rene Stranzenbach, Elisabeth Livingstone, Rudolf Stadler, Kerstin Steinbrink, Rose K C Moritz, Hans Theodor Eich

Journal: Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG 2022;20(3):279-285

PMID: 34984837

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.

© 2022 The Authors. Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft.

Address: Department of Radiation Oncology, University Hospital of Muenster, Munster, Germany.; Department of Dermatology and Venerology, Martin-Luther-University Halle-Wittenberg, Halle, Germany.; Department of Dermatology, University Hospital of Muenster, Munster, Germany.; Department of Dermatology, University Hospital of Bochum, Bochum, Germany.; Department of Dermatology, University Hospital of Essen, Essen, Germany.; Department of Dermatology, Johannes Wesling Medical Centre, University of Bochum, Minden, German.
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