International study of SS shows superiority of combination therapy & heterogeneity of treatment strategies
Author
Campbell, Belinda ADobos, Gabor
Haider, Zahra
Prince, H Miles
Bagot, Martine
Evison, Felicity
Van Der Weyden, Carrie
McCormack, Christopher John
Ram-Wolff, Caroline
Miladi, Maryam
Scarisbrick, Julia J
Publication date
2023-08-30
Metadata
Show full item recordAbstract
Despite increasing availability of therapies, patients with Sezary syndrome (SS) commonly endure multi-line treatment journeys, mostly with partial responses of short duration. Measuring clinical benefit is challenging; time-to-next-treatment (TTNT) provides a robust, objective measurement of efficacy. This international observational study, from three quaternary centers, examines patterns of clinical care and therapeutic benefit as measured by TTNT. TTNT was calculated for monotherapies and combination therapies, with consideration given to treatment line. 178 patients with SS (73% de novo, 27% secondary) were included, receiving 721 lines of systemic therapy, with median follow-up of 56.9 months. Across all lines, 58 different therapeutic regimens were prescribed (54 were systemic therapies), and classified into 17 treatment groups. First-line, the most common treatments were extracorporeal photopheresis (ECP)-containing combination therapy (20%) and retinoid monotherapy (19%). Median TTNT for all first-line therapies was short (5.4 months). First-line, combination therapies had longer median TTNT than monotherapies: 10.0 vs 5.0 months (p=0.004), respectively. Later delivery of combination therapies was associated with shorter clinical benefit, with median TTNT reduced to 6.2 and 2.2 months for midline (2nd-4th line) and late line (>4th line), respectively (p<0.001). First-line, ECP-containing treatments were associated with longer median TTNT compared to non ECP-containing treatments: 9.0 vs 4.9 months (p=0.007). For both ECP-monotherapy and ECP-containing combination therapy, significant reductions in TTNT were seen in later lines. These data suggest therapeutic benefit from first-line delivery of combination therapy for patients with SS, and favor early inclusion of ECP in the treatment algorithm for those who can access it.Citation
Campbell BA, Dobos G, Haider Z, Prince HM, Bagot M, Evison F, van der Weyden C, McCormack C, Ram-Wolff C, Miladi M, Scarisbrick JJ. International study of treatment efficacy in SS shows superiority of combination therapy and heterogeneity of treatment strategies. Blood Adv. 2023 Nov 14;7(21):6639-6647. doi: 10.1182/bloodadvances.2023011041.Type
ArticleAdditional Links
https://ashpublications.org/bloodadvancesPMID
37648672Journal
Blood AdvancesPublisher
American Society of Hematologyae974a485f413a2113503eed53cd6c53
10.1182/bloodadvances.2023011041