Safety and efficacy of bexarotene for Japanese patients with cutaneous T‐cell lymphoma: Real‐world experience from post‐marketing surveillance

Autor: Akimichi Morita, Noriko Makita, Katsunori Manaka, Kazuyasu Fujii, Hiraku Suga, Chikako Nishigori, Takeru Funakoshi, Hideki Nakajima, Makoto Sugaya, Toshihisa Hamada, Yoshihito Shimoyama, Ikko Muto, Eiji Nakano, Tomomitsu Miyagaki, Hikari Boki, Takatoshi Shimauchi, Riichiro Abe, Taku Fujimura, Chiharu Tateishi, Masahiro Amano, Yoji Hirai, Kentaro Yonekura, Eiji Kiyohara
Rok vydání: 2021
Předmět:
Zdroj: The Journal of Dermatology. 49:253-262
ISSN: 1346-8138
0385-2407
DOI: 10.1111/1346-8138.16201
Popis: To establish real-world evidence about the safety and efficacy of bexarotene for Japanese patients with cutaneous T-cell lymphoma, we conducted a nationwide cohort study using data from post-marketing surveillance for bexarotene treatment. In total, 294 patients with cutaneous T-cell lymphoma were identified between June 2016 and June 2018. Of these, 267 patients were included as the safety analysis set. Of the 267 patients, 175 were included in the efficacy analysis set. Of these, 139 patients had mycosis fungoides, including 46 with early stage disease and 93 with advanced stage disease. Among the 139 patients with mycosis fungoides, the objective response rate was 46.8%. A significant difference in objective response rate was detected between patients who started with bexarotene at 300 mg/m2 (61.6%) and patients who started with bexarotene at less than 300 mg/m2 (22.6%, p < 0.001). Of the 139 patients with mycosis fungoides, 92 were treated with a combination of bexarotene plus photo(chemo)therapy. A significant difference in objective response rate was seen between bexarotene with a combination of photo(chemo)therapy (57.6%) and bexarotene without a combination of photo(chemo)therapy (25.5%, p < 0.001). Starting bexarotene at 300 mg/m2 and combination with photo(chemo)therapy were detected as independent factors influencing response. Common treatment-related adverse events included hypothyroidism (85.8%), hypertriglyceridemia (68.5%), hypercholesterolemia (43.8%), and neutropenia (21.3%). Hypertriglyceridemia, hypercholesterolemia, and neutropenia occurred more frequently in patients who started with bexarotene at 300 mg/m2 than patients who started with bexarotene at less than 300 mg/m2 (hypertriglyceridemia, 76.4% vs. 57.0%, p = 0.001; hypercholesterolemia, 49.0% vs. 36.4%, p = 0.045; neutropenia, 28.0% vs. 12.1%, p = 0.002; respectively). The present study indicates that starting bexarotene at 300 mg/m2 and combination of photo(chemo)therapy offer a promising efficacy for the treatment of patients with mycosis fungoides. Efficacy of low-dose bexarotene plus photo(chemo)therapy should be evaluated in future.
Databáze: OpenAIRE
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