Cutaneous T cell lymphoma treated with mogamulizumab monotherapy and mogamulizumab plus etoposide combined therapy: A real-world case series

Since the efficacy of mogamulizumab has been confirmed by a phase III, randomized study, mogamulizumab is one of the promising first-line therapies for advanced cutaneous T cell lymphoma (CTCL), though its efficacy is not completely satisfactory. Therefore, several anti-lymphoma drugs such as etoposide were recently used to enhance the anti-tumor effects of mogamulizumab for the treatment of mycosis fungoides (MF). In this report, the anti-tumor effects of mogamulizumab and post mogamulizumab therapy were retrospectively evaluated in 11 cases of CTCL in real-world clinical practice. The best response rate (RR) was 45.5% (95% confidence interval [CI], 21.3%–72.0%) for the total cohort, 50.0% (95%CI, 21.5%–78.5%) for the MF cohort, and 33.3% (95%CI, 5.6%–79.8%) for the primary cutaneous peripheral T cell lymphoma not otherwise specified (PCPTCL-NOS) cohort. The objective response rate (ORR) at 1 month (ORR1) for the total cohort was 45.5% (95%CI, 21.3%–72.0%), and ORR at 4 months (ORR4) was 27.3% (95%CI, 9.2%–57.1%). The mean time to next treatment (TTNT) was 16.0 weeks (3–100 weeks) for all patients, 16.5 months (3–100 weeks) for the MF cohort, and 9.0 (7–16) weeks for the PCPTCL-NOS cohort. The efficacy rate of etoposide-based therapy was 71.4% (95%CI, 35.9%–98.0%) for all patients, 80% (95%CI, 35.9%–98.0%) in the MF cohort, and 50% (95%CI, 9.5%–90.5%) in the PCPTCL-NOS cohort. The median duration of response was 182 (45–323) weeks. The safety profile of mogamulizumab monotherapy in the present cohort was comparable to the previous phase III, randomized trial. The present study suggests that the efficacy and safety profiles of mogamulizumab monotherapy as second-line therapy and beyond in a real-world Japanese cohort were comparable to those in the previous phase III, randomized trial.