Mogamulizumab in combination improves clinical outcomes in relapsed and refractory Sézary syndrome
IntroductionSézary syndrome (SS) is an aggressive variant of cutaneous T-cell lymphoma (CTCL) that presents with generalized erythroderma, lymphadenopathy, peripheral blood involvement, and severe pruritus. Unfortunately, the disease can relapse or progress and generally has a poor prognosis. Mogamu...
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Frontiers Media S.A.
2025-05-01
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| author | Jordan Pilkington Sophia Ly Delice Kayishunge Cesar Gentille Henry K. Wong Henry K. Wong |
| author_facet | Jordan Pilkington Sophia Ly Delice Kayishunge Cesar Gentille Henry K. Wong Henry K. Wong |
| author_sort | Jordan Pilkington |
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| description | IntroductionSézary syndrome (SS) is an aggressive variant of cutaneous T-cell lymphoma (CTCL) that presents with generalized erythroderma, lymphadenopathy, peripheral blood involvement, and severe pruritus. Unfortunately, the disease can relapse or progress and generally has a poor prognosis. Mogamulizumab is a targeted monoclonal antibody that has been shown to be effective in relapsed disease, with particular benefit in the blood compartment, and has received the U.S. Food and Drug Administration (FDA) approval for CTCL. Data regarding the combination of mogamulizumab with other systemic treatments for CTCL are limited. Here, we present clinical outcomes in a real-world setting where patients with SS were treated using a mogamulizumab-based multi-agent approach.Methods and resultsWe conducted a retrospective chart review of patients in a Cutaneous Lymphoma Clinic and identified 10 patients that met the International Society for Cutaneous Lymphomas (ISCL)/European Organization of Research and Treatment of Cancer (EORTC) diagnostic criteria for SS and were treated with mogamulizumab. These patients received at least four prior therapies, including systemics and topicals. All patients received mogamulizumab in addition to other systemic therapies. Responses were commonly observed in the blood after the first cycle. Global response, determined by assessment in four compartments including the skin, blood, viscera, and lymph nodes, identified four patients that achieved complete remission, three with partial response, two that maintained a stable disease, and one patient that experienced disease progression. The therapies most frequently used in combination were bexarotene and interferon. The median duration of response in our patient population was 23.5 months.ConclusionIn this case series, a multi-agent approach combining mogamulizumab with traditional CTCL systemic agents was well tolerated and was effective in the treatment of relapsed or refractory SS and led to a period of extended clinical improvement. |
| format | Article |
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| issn | 2813-3935 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Hematology |
| spelling | doaj-art-d8d94b15ed2249abb3728888f2ef49c02025-08-20T02:31:12ZengFrontiers Media S.A.Frontiers in Hematology2813-39352025-05-01410.3389/frhem.2025.15576411557641Mogamulizumab in combination improves clinical outcomes in relapsed and refractory Sézary syndromeJordan Pilkington0Sophia Ly1Delice Kayishunge2Cesar Gentille3Henry K. Wong4Henry K. Wong5Department of Hematology-Oncology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United StatesDepartment of Hematology-Oncology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United StatesDepartment of Hematology-Oncology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United StatesWinthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, United StatesDepartment of Hematology-Oncology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United StatesDepartment of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, United StatesIntroductionSézary syndrome (SS) is an aggressive variant of cutaneous T-cell lymphoma (CTCL) that presents with generalized erythroderma, lymphadenopathy, peripheral blood involvement, and severe pruritus. Unfortunately, the disease can relapse or progress and generally has a poor prognosis. Mogamulizumab is a targeted monoclonal antibody that has been shown to be effective in relapsed disease, with particular benefit in the blood compartment, and has received the U.S. Food and Drug Administration (FDA) approval for CTCL. Data regarding the combination of mogamulizumab with other systemic treatments for CTCL are limited. Here, we present clinical outcomes in a real-world setting where patients with SS were treated using a mogamulizumab-based multi-agent approach.Methods and resultsWe conducted a retrospective chart review of patients in a Cutaneous Lymphoma Clinic and identified 10 patients that met the International Society for Cutaneous Lymphomas (ISCL)/European Organization of Research and Treatment of Cancer (EORTC) diagnostic criteria for SS and were treated with mogamulizumab. These patients received at least four prior therapies, including systemics and topicals. All patients received mogamulizumab in addition to other systemic therapies. Responses were commonly observed in the blood after the first cycle. Global response, determined by assessment in four compartments including the skin, blood, viscera, and lymph nodes, identified four patients that achieved complete remission, three with partial response, two that maintained a stable disease, and one patient that experienced disease progression. The therapies most frequently used in combination were bexarotene and interferon. The median duration of response in our patient population was 23.5 months.ConclusionIn this case series, a multi-agent approach combining mogamulizumab with traditional CTCL systemic agents was well tolerated and was effective in the treatment of relapsed or refractory SS and led to a period of extended clinical improvement.https://www.frontiersin.org/articles/10.3389/frhem.2025.1557641/fullSézary syndromecutaneous T-cell lymphoma (CTCL)mogamulizumabmogamulizumab-associated rashbexarotenerefractory Sézary syndrome |
| spellingShingle | Jordan Pilkington Sophia Ly Delice Kayishunge Cesar Gentille Henry K. Wong Henry K. Wong Mogamulizumab in combination improves clinical outcomes in relapsed and refractory Sézary syndrome Frontiers in Hematology Sézary syndrome cutaneous T-cell lymphoma (CTCL) mogamulizumab mogamulizumab-associated rash bexarotene refractory Sézary syndrome |
| title | Mogamulizumab in combination improves clinical outcomes in relapsed and refractory Sézary syndrome |
| title_full | Mogamulizumab in combination improves clinical outcomes in relapsed and refractory Sézary syndrome |
| title_fullStr | Mogamulizumab in combination improves clinical outcomes in relapsed and refractory Sézary syndrome |
| title_full_unstemmed | Mogamulizumab in combination improves clinical outcomes in relapsed and refractory Sézary syndrome |
| title_short | Mogamulizumab in combination improves clinical outcomes in relapsed and refractory Sézary syndrome |
| title_sort | mogamulizumab in combination improves clinical outcomes in relapsed and refractory sezary syndrome |
| topic | Sézary syndrome cutaneous T-cell lymphoma (CTCL) mogamulizumab mogamulizumab-associated rash bexarotene refractory Sézary syndrome |
| url | https://www.frontiersin.org/articles/10.3389/frhem.2025.1557641/full |
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