Global patterns of care in advanced stage mycosis fungoides/Sezary syndrome: a multicenter retrospective follow-up study from the Cutaneous Lymphoma International Consortium
| Autor: | Alessandro Pileri, K. Rogers, G. Ognibene, C. Postigo-Llorente, Larisa J. Geskin, M. Kheterpal, S. Alberti Violetti, Daniela Zugna, Paolo Fava, Youn H. Kim, V. Nikolaou, A. Stevens, Evangelia Papadavid, Joan Guitart, Nicola Pimpinelli, P L Ortiz-Romero, Emilio Berti, Ch. Antoniou, Iris Amitay-Laish, F. Child, René Stranzenbach, Tomomitsu Miyagaki, Denis Miyashiro, R. Knobler, Pier Luigi Zinzani, Maarten H. Vermeer, Teresa Estrach, Francesco Onida, Stephen Morris, S. Chaganti, Martina Sanlorenzo, Ellen Kim, Cristina Muniesa, José Antonio Sanches, Pietro Quaglino, Makoto Sugaya, M. Duvic, J. Scarisbrick, N. Spaccarelli, Vieri Grandi, Steve Horwitz, Simona Osella-Abate, Alain H. Rook, Martine Bagot, Chiara Astrua, Octavio Servitje, Emmilia Hodak, Rakhshandra Talpur, Sean Whittaker, Milena Maule, Christopher McCormack, S. Fabbro, A. Combalia, Rein Willemze, Rudolf Stadler, Estela Martinez-Escala, Pierluigi Porcu, S. Porkert, M.T. Fierro, Caroline Ram-Wolff, Simone Ribero, Henry Miles Prince, Richard T. Hoppe, Constanze Jonak |
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| Přispěvatelé: | Quaglino, P, Maule, M, Prince, H. M, Porcu, P, Horwitz, S, Duvic, M, Talpur, R, Vermeer, M, Bagot, M, Guitart, J, Papadavid, E, Sanches, J. A, Hodak, E, Sugaya, M, Berti, E, Ortiz-Romero, P, Pimpinelli, N, Servitje, O, Pileri, A, Zinzani, P. L, Estrach, T, Knobler, R, Stadler, R, Fierro, M. T, Alberti Violetti, S, Amitay-Laish, I, Antoniou, C, Astrua, C, Chaganti, S, Child, F, Combalia, A, Fabbro, S, Fava, P, Grandi, V, Jonak, C, Martinez-Escala, E, Kheterpal, M, Kim, E. J, Mccormack, C, Miyagaki, T, Miyashiro, D, Morris, S, Muniesa, C, Nikolaou, V, Ognibene, G, Onida, F, Osella-Abate, S, Porkert, S, Postigo-Llorente, C, Ram-Wolff, C, Ribero, S, Rogers, K, Sanlorenzo, M, Stranzenbach, R, Spaccarelli, N, Stevens, A, Zugna, D, Rook, A. H, Geskin, L. J, Willemze, R, Whittaker, S, Hoppe, R, Scarisbrick, J, Kim, Y. |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Oncology
Male medicine.medical_treatment Medical Oncology Cutaneous lymphoma 030207 dermatology & venereal diseases 0302 clinical medicine Photopheresis CTCL Japan Child Bexarotene Aged 80 and over treatment Follow up studies Hematology Middle Aged Chemotherapy regimen Europe Mycosis fungoides Prognosis Survival Treatment 030220 oncology & carcinogenesis Female prognosi Brazil medicine.drug mycosis fungoide Mycosis fungoides/Sezary syndrome Adult medicine.medical_specialty Adolescent survival 03 medical and health sciences Young Adult Internal medicine medicine Humans Sezary Syndrome Aged Neoplasm Staging Retrospective Studies Patterns of care Chlorambucil business.industry mycosis fungoides Advanced stage Australia Retrospective cohort study medicine.disease Dermatology Gemcitabine United States Relative risk prognosis business |
| Zdroj: | Annals of Oncology, 28(10), 2517-2525 |
| Popis: | Background Advanced-stage mycosis fungoides (MF)/Sezary syndrome (SS) patients are weighted by an unfavorable prognosis and share an unmet clinical need of effective treatments. International guidelines are available detailing treatment options for the different stages but without recommending treatments in any particular order due to lack of comparative trials. The aims of this second CLIC study were to retrospectively analyze the pattern of care worldwide for advanced-stage MF/SS patients, the distribution of treatments according to geographical areas (USA versus non-USA), and whether the heterogeneity of approaches has potential impact on survival. Patients and methods This study included 853 patients from 21 specialist centers (14 European, 4 USA, 1 each Australian, Brazilian, and Japanese). Results Heterogeneity of treatment approaches was found, with up to 24 different modalities or combinations used as first-line and 36% of patients receiving four or more treatments. Stage IIB disease was most frequently treated by total-skin-electron-beam radiotherapy, bexarotene and gemcitabine; erythrodermic and SS patients by extracorporeal photochemotherapy, and stage IVA2 by polychemotherapy. Significant differences were found between USA and non-USA centers, with bexarotene, photopheresis and histone deacetylase inhibitors most frequently prescribed for first-line treatment in USA while phototherapy, interferon, chlorambucil and gemcitabine in non-USA centers. These differences did not significantly impact on survival. However, when considering death and therapy change as competing risk events and the impact of first treatment line on both events, both monochemotherapy (SHR = 2.07) and polychemotherapy (SHR = 1.69) showed elevated relative risks. Conclusion This large multicenter retrospective study shows that there exist a large treatment heterogeneity in advanced MF/SS and differences between USA and non-USA centers but these were not related to survival, while our data reveal that chemotherapy as first treatment is associated with a higher risk of death and/or change of therapy and thus other therapeutic options should be preferable as first treatment approach. |
| Databáze: | OpenAIRE |
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