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Zengarini C, Guglielmo A, Mussi M, Motta G, Agostinelli C, Sabattini E, Piraccini BM, Pileri A. A Narrative Review of the State of the Art of CCR4-Based Therapies in Cutaneous T-Cell Lymphomas: Focus on Mogamulizumab and Future Treatments. Antibodies (Basel) 2024; 13:32. [PMID: 38804300 PMCID: PMC11130839 DOI: 10.3390/antib13020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 05/29/2024] Open
Abstract
The CCR4 receptor is a pivotal target in cutaneous T-cell lymphoma (CTCL) therapy due to its role in impairing immune responses against malignant T-cells and expression profiles. Monoclonal antibodies like mogamulizumab effectively bind to CCR4, reducing tumour burden and enhancing patient outcomes by inhibiting the receptor's interaction with ligands, thereby hindering malignant T-cell migration and survival. Combining CCR4 antibodies with chemotherapy, radiation, and other drugs is being explored for synergistic effects. Additionally, small-molecular inhibitors, old pharmacological agents interacting with CCR4, and CAR-T therapies are under investigation. Challenges include drug resistance, off-target effects, and patient selection, addressed through ongoing trials refining protocols and identifying biomarkers. Despite advancements, real-life data for most of the emerging treatments are needed to temper expectations. In conclusion, CCR4-targeted therapies show promise for CTCL management, but challenges persist. Continued research aims to optimise treatments, enhance outcomes, and transform CTCL management. This review aims to elucidate the biological rationale and the several agents under various stages of development and clinical evaluation with the actual known data.
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Affiliation(s)
- Corrado Zengarini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (C.Z.)
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Alba Guglielmo
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy
| | - Martina Mussi
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (C.Z.)
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giovanna Motta
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (C.Z.)
- Division of Haematopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Claudio Agostinelli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (C.Z.)
- Division of Haematopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Elena Sabattini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (C.Z.)
- Division of Haematopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Bianca Maria Piraccini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (C.Z.)
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Alessandro Pileri
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (C.Z.)
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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Sonego B, Ibatici A, Rivoli G, Angelucci E, Sola S, Massone C. Histopathological Markers for Target Therapies in Primary Cutaneous Lymphomas. Cells 2023; 12:2656. [PMID: 37998391 PMCID: PMC10670482 DOI: 10.3390/cells12222656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
In recent years, targeted (biological) therapies have become available also for primary cutaneous T-cell lymphomas (PCTCLs) including anti-CD30 (brentuximab vedotin) in mycosis fungoides, primary cutaneous anaplastic large T-cell lymphoma, lymphomatoid papulosis; anti-CCR4 (mogamulizumab) in Sezary syndrome; anti-CD123 (tagraxofusp) in blastic plasmocytoid cell neoplasm. Moreover, anti-PD1 (nivolumab), anti-PDL1 (pembrolizumab, atezolizumab), anti-CD52 (alemtuzumab), anti-KIR3DL2-CD158k (lacutamab), and anti-CD70 (cusatuzumab) have been tested or are under investigations in phase II trials. The expression of these epitopes on neoplastic cells in skin biopsies or blood samples plays a central role in the management of PCTCL patients. This narrative review aims to provide readers with an update on the latest advances in the newest therapeutic options for PCTCLs.
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Affiliation(s)
- Benedetta Sonego
- Dermatology Clinic, University of Trieste, 35125 Trieste, Italy;
| | - Adalberto Ibatici
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.I.); (G.R.); (E.A.)
| | - Giulia Rivoli
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.I.); (G.R.); (E.A.)
| | - Emanuele Angelucci
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.I.); (G.R.); (E.A.)
| | - Simona Sola
- Surgical Pathology, Galliera Hospital, 16128 Genoa, Italy;
| | - Cesare Massone
- Dermatology Unit & Scientific Directorate, Galliera Hospital, 16128 Genoa, Italy
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Filippi L, Proietti I, Petrozza V, Aversa S, Fiorentino F, Potenza C, Bagni O, Schillaci O, Cantonetti M. [ 18F]FDG PET/CT in a Case of Mycosis Fungoides Showing an Unusual Adverse Reaction to Mogamulizumab: Correlation Between Imaging and Histological Findings. Cancer Biother Radiopharm 2023; 38:268-272. [PMID: 36706264 DOI: 10.1089/cbr.2022.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
A 73-year-old female patient, affected by mycosis fungoides (MF), discontinued mogamulizumab, after initial clinical benefit, due to the onset of generalized erythema. Follow-up positron emission computed tomography (PET/CTs) carried out at 3 weeks and 6 months after therapy discontinuation showed, with respect to baseline PET/CT scan, a progressively increasing number of hypermetabolic enlarged lymph nodes suspected for a neoplastic involvement, but with histology indicative of an inflammatory reaction. After sequential therapy with corticosteroids and methotrexate, a complete remission was registered at 18F-fluorodeoxyglucose ([18F]FDG) PET/CT performed at 12 months after mogamulizumab interruption. The case we describe highlights the usefulness of serial examinations with [18F]FDG PET/CT in an MF patient presenting an unusual adverse reaction to mogamulizumab.
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Affiliation(s)
- Luca Filippi
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Ilaria Proietti
- Dermatology Unit "Daniele Innocenzi," "A. Fiorini" Hospital, Terracina, Italy
| | - Vincenzo Petrozza
- Pathology Unit, Department of Medico-Surgical Sciences and Biotechnologies, ICOT Hospital, University of Rome "La Sapienza," Italy
| | - Sara Aversa
- Pathology Unit, Department of Medico-Surgical Sciences and Biotechnologies, ICOT Hospital, University of Rome "La Sapienza," Italy
| | - Francesco Fiorentino
- Pathology Unit, Santa Maria Goretti Hospital of Latina-ASL Latina, Latina, Italy
| | - Concetta Potenza
- Dermatology Unit "Daniele Innocenzi," "A. Fiorini" Hospital, Terracina, Italy
| | - Oreste Bagni
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Maria Cantonetti
- Hematology, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
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Roccuzzo G, Giordano S, Avallone G, Rubatto M, Canonico S, Funaro A, Ortolan E, Senetta R, Fava P, Fierro MT, Ribero S, Quaglino P. Sézary Syndrome: Different Erythroderma Morphological Features with Proposal for a Clinical Score System. Cells 2022; 11:cells11030333. [PMID: 35159143 PMCID: PMC8834570 DOI: 10.3390/cells11030333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 11/23/2022] Open
Abstract
Sézary syndrome is a rare subtype of cutaneous T-cell lymphoma characterized by erythroderma, peripheral lymphadenopathies, and circulating atypical cerebriform T-cells. To date, no definite staging system has been developed for these patients. In this retrospective analysis of the archive of the Dermatological Clinic of the University of Turin, Italy, erythrodermic SS patients were classified according to clinical records and photographs into three main presentations: erythematous, infiltrated, or melanodermic. The pattern of erythroderma was found to be associated with disease outcome, as better survivals were recorded in patients with erythematous and infiltrative erythroderma. Patients in the melanodermic group, though less represented in our investigation, seemed to show a worse trend in survival. According to this preliminary evidence, a new prognostic classification, with a revised score specific for Sézary syndrome patients, can be proposed to usefully integrate the current staging system. The correlation displayed in our research will be hopefully confirmed by prospective studies with larger cohorts, with the aim of identifying significant prognostic features in this subset of cutaneous T-cell lymphoma patients.
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Affiliation(s)
- Gabriele Roccuzzo
- Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (S.G.); (G.A.); (M.R.); (S.C.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
- Correspondence: ; Tel.: +39-011-6335-843
| | - Silvia Giordano
- Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (S.G.); (G.A.); (M.R.); (S.C.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Gianluca Avallone
- Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (S.G.); (G.A.); (M.R.); (S.C.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Marco Rubatto
- Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (S.G.); (G.A.); (M.R.); (S.C.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Silvia Canonico
- Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (S.G.); (G.A.); (M.R.); (S.C.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Ada Funaro
- Laboratory of Immunogenetics, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.F.); (E.O.)
| | - Erika Ortolan
- Laboratory of Immunogenetics, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.F.); (E.O.)
| | - Rebecca Senetta
- Pathology Unit, Department of Oncology, University of Turin, 10126 Torino, Italy;
| | - Paolo Fava
- Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (S.G.); (G.A.); (M.R.); (S.C.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Maria Teresa Fierro
- Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (S.G.); (G.A.); (M.R.); (S.C.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Simone Ribero
- Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (S.G.); (G.A.); (M.R.); (S.C.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Pietro Quaglino
- Section of Dermatology, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (S.G.); (G.A.); (M.R.); (S.C.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
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