Treatment of early‐stage mycosis fungoides: results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study*
Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study is a prospective analysis of an international database. Here we examine front-line treatments and quality of life (QoL) in patients with newly diagnosed mycosis fungoides (MF). OBJECTIVES: To identify (i) differences in first-line approaches according to tumour-nodes-metastasis-blood (TNMB) staging; (ii) parameters related to a first-line systemic approach and (iii) response rates and QoL measures. METHODS: In total, 395 newly diagnosed patients with early-stage MF (stage IA-IIA) were recruited from 41 centres in 17 countries between 1 January 2015 and 31 December 2018 following central clinicopathological review. RESULTS: The most common first-line therapy was skin-directed therapy (SDT) (322 cases, 81·5%), while a smaller percentage (44 cases, 11·1%) received systemic therapy. Expectant observation was used in 7·3%. In univariate analysis, the use of systemic therapy was significantly associated with higher clinical stage (IA, 6%; IB, 14%; IIA, 20%; IA-IB vs. IIA, P < 0·001), presence of plaques (T1a/T2a, 5%; T1b/T2b, 17%; P < 0·001), higher modified Severity Weighted Assessment Tool (> 10, 15%; ≤ 10, 7%; P = 0·01) and folliculotropic MF (FMF) (24% vs. 12%, P = 0·001). Multivariate analysis demonstrated significant associations with the presence of plaques (T1b/T2b vs. T1a/T2a, odds ratio 3·07) and FMF (odds ratio 2·83). The overall response rate (ORR) to first-line SDT was 73%, while the ORR to first-line systemic treatments was lower (57%) (P = 0·027). Health-related QoL improved significantly both in patients with responsive disease and in those with stable disease. CONCLUSIONS: Disease characteristics such as presence of plaques and FMF influence physician treatment choices, and SDT was superior to systemic therapy even in patients with such disease characteristics. Consequently, future treatment guidelines for early-stage MF need to address these issues.
Source: British Journal of Dermatology
DOI: 10.1111/bjd.19252
Authors: P. Quaglino, H.M. Prince, R. Cowan, M. Vermeer, E. Papadavid, M. Bagot, O. Servitjie, E. Berti, E. Guenova, R. Stadler, C. Querfeld, A.M. Busschots, E. Hodak, A. Patsatsi, J. Sanches, M. Maule, J. Yoo, M. Kevin, P. Fava, S. Ribero, L. Zocchi, M. Rubatto, M.T. Fierro, U. Wehkamp, M. Marshalko, C. Mitteldorf, O. Akilov, P. Ortiz‐Romero, T. Estrach, L. Vakeva, P.A. Enz, M. Wobser, M. Bayne, C. Jonak, M. Rubeta, A. Forbes, A. Bates, M. Battistella, R. Amel‐Kashipaz, B. Vydianath, A. Combalia, E. Georgiou, E. Hauben, E.K. Hong, M. Jost, R. Knobler, I. Amitay‐Laish, D. Miyashiro, J. Cury‐Martins, X. Martinez, C. Muniesa, H. Prag‐Naveh, A. Stratigos, V. Nikolaou, K. Quint, C. Ram‐Wolff, K. Rieger, R. Stranzenbach, Á. Szepesi, S. Alberti‐Violetti, E. Felicity, L. Cerroni, W. Kempf, S. Whittaker, R. Willemze, Y. Kim, J.J. Scarisbrick
Institutions: University of Turin, The University of Melbourne, Peter MacCallum Cancer Centre, The Christie Hospital, Leiden University, Leiden University Medical Center, National and Kapodistrian University of Athens, Hôpital Saint-Louis, Bellvitge University Hospital, University of Milan, University Hospital Zurich, Johannes Wesling Klinikum Minden, City Of Hope National Medical Center, Beckman Research Institute, Universitair Ziekenhuis Leuven, Tel Aviv University, Rabin Medical Center, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Universidade de São Paulo, University Hospital Schleswig-Holstein, Semmelweis University, Universitätsmedizin Göttingen, University of Pittsburgh, Hospital Universitario 12 De Octubre, Hospital Clínic de Barcelona, Universitat de Barcelona, Helsinki University Hospital, Hospital Italiano de Buenos Aires, Universitätsklinikum Würzburg, Poole Hospital, Poole Hospital NHS Foundation Trust, Medical University of Vienna, Churchill Hospital, Oxford University Hospitals NHS Trust, Torbay Hospital, University Hospital Southampton NHS Foundation Trust, Stanford University, Medical University of Graz, King's College London, Guy's and St Thomas' NHS Foundation Trust, University Hospitals Birmingham NHS Foundation Trust
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3032573360