Skin Response to Mogamulizumab in Patients With Mycosis Fungoides and Sezary Syndrome: A Retrospective, Real World Cohort.
Academic Article
Overview
abstract
BACKGROUND: Mogamulizumab is more effective in treating the blood component of mycosis fungoides (MF) and Sezary syndrome (SS), though some patients also experience significant skin improvement. The characteristics distinguishing those with a favorable skin response remain unclear. OBJECTIVES: This study aimed to characterize MF/SS patients achieving skin response on mogamulizumab. METHODS: A retrospective chart review at a single cancer center included adult MF/SS patients who received at least one mogamulizumab cycle with follow-up. Skin response (≥ 50% clearance) and blood response (≥ 50% decrease in neoplastic cells/µL) were assessed alongside demographics, disease staging, and prior therapies. RESULTS: Among 56 patients (MF = 35; SS = 21), 43% achieved skin response, with a median time of 2.3 months (range 0.5-6.4). Blood response occurred in 90%, with a median time of 1.8 months (range 0.2-23). Skin-response was highest in patients with blood response (64%), blood disease (B2, 61%), and SS (57%) and was significantly associated with decreasing circulating Sezary cells (P < .001). Among patients without blood involvement (B0), 24% achieved skin response, primarily in erythrodermic cases (71% versus 11%, P = .01). CONCLUSIONS: Mogamulizumab appears effective in inducing skin responses, particularly in advanced-stage and high blood-stage disease. Even in patients without blood compartment involvement, mogamulizumab therapy may still be beneficial, especially for patients with erythroderma. Skin responses are less common in early-stage MF. Patients with both advanced blood and skin disease may benefit from initiating mogamulizumab simultaneously with skin-directed therapy.
