KEY TAKEAWAYS
- The study aimed to identify first-line approach differences by TNMB staging, systemic approach parameters, response rates, and QoL.
- The study concluded that SDT is superior to systemic therapy in early-stage MF, impacting future treatment guidelines.
The PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study is a prospective analysis of an international database. This analysis examines front-line treatments and quality of life (QoL) in patients with newly diagnosed mycosis fungoides (MF), a most common form of cutaneous T-cell lymphoma (CTCL), a type of cancer that affects T cells, a type of white blood cell that fights infection, in the skin.
Elijah Rodriguez and the team aimed to identify differences in first-line approaches based on tumor-nodes-metastasis-blood (TNMB) staging, parameters related to a first-line systemic approach, and response rates and QoL measures.
About 395 newly diagnosed patients with early-stage MF (stage IA-IIA) were recruited from 41 centers in 17 countries between January 1, 2015, and December 31, 2018, following a central clinicopathological review.
The most common first-line therapy was skin-directed therapy (SDT), used in 322 cases (81.5%), while a smaller percentage (44 cases, 11.1%) received systemic therapy. Expectant observation was used in 7.3% of cases.
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 scores (>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 (OR 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 in both patients with responsive disease and those with stable disease.
The study concluded that disease characteristics, such as the presence of plaques and FMF, influence physician treatment choices. SDT was found to be superior to systemic therapy, even in patients with these characteristics. Consequently, future treatment guidelines for early-stage MF should address these issues.
Funding was not applicable.
Source: https://pubmed.ncbi.nlm.nih.gov/38844623/
Rodriguez E, Needle CD, Martinez MJ, et al. (2024). “Predictors for the use of systemic therapy in stage IB Mycosis fungoides.” Arch Dermatol Res. 2024 Jun 6;316(6):337. doi: 10.1007/s00403-024-03005-0. PMID: 38844623.
