Advances in Immunotherapy for the Treatment of Cutaneous T-Cell Lymphoma

Figures & data

Figure 1 Cell surface targets and mechanisms of action of monoclonal antibodies in current use or under investigation in CTCL. Created with BioRender.com.

Table 1 Currently Available Immunotherapy Agents for CTCL

Drug	Level of Evidence	Diseases	Efficacy	Toxicity
Mogamulizumab	Phase 3^Citation33	MF, SS	ORR 28%, PFS 8 mos DOR 14 mos Improvement over HDAC in stage III/IV, SS	Infusion reaction Drug rash Diarrhea Fatigue
Brentuximab vedotin	Phase 3^Citation46	pcALCL, CD30+ MF*	ORR 56% PFS 17 mos DOR 15 mos	Neuropathy
Pembrolizumab	Phase 2^Citation63	MF, SS	38% DOR not reached	irAE
Alemtuzumab	Phase 2^Citation23	MF, SS	ORR 55%, CR 32% ORR in SS 86% DOR 12 mos	CMV reactivation Severe infection

Note: *No difference noted in prespecified subgroups of CD30 expression, but post hoc analysis showed significantly less response in patients with <5% expression, and ALCANZA trial only enrolled patients with at least 10% CD30+ malignant or lymphoid infiltrative cells.

Kim YH, Bagot M, Pinter-Brown L, et al. Mogamulizumab versus vorinostat in previously treated cutaneous T-cell lymphoma (MAVORIC): an international, open-label, randomised, controlled phase 3 trial. Lancet Oncol. 2018;19(9):1192–1204. doi:10.1016/S1470-2045(18)30379-6

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Prince HM, Kim YH, Horwitz SM, et al. Brentuximab vedotin or physician’s choice in CD30-positive cutaneous T-cell lymphoma (ALCANZA): an international, open-label, randomised, phase 3, multicentre trial. Lancet. 2017;390(10094):555–566. doi:10.1016/S0140-6736(17)31266-7

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Khodadoust MS, Rook AH, Porcu P, et al. Pembrolizumab in relapsed and refractory mycosis fungoides and sezary syndrome: a multicenter phase II study. J Clin Oncol. 2020;38(1):20–28. doi:10.1200/JCO.19.01056

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Lundin J, Hagberg H, Repp R, et al. Phase 2 study of alemtuzumab (anti-CD52 monoclonal antibody) in patients with advanced mycosis fungoides/Sezary syndrome. Blood. 2003;101(11):4267–4272. doi:10.1182/blood-2002-09-2802

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