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Bozonnat A, Beylot-Barry M, Dereure O, D’Incan M, Quereux G, Guenova E, Perier-Muzet M, Dalle S, Grange F, Viguier MA, Ram-Wolff C, Feldmeyer L, Beltraminelli H, Bonnet N, Amatore F, Maubec E, Franck N, Machet L, Chasset F, Brunet-Possenti F, Bouaziz JD, Battistella M, Donzel M, Pham-Ledard A, Bejar C, Moins-Teisserenc H, Mourah S, Saiag P, Hainaut E, Michel C, Bens G, Adamski H, Aubin F, Boulinguez S, Joly P, Tedbirt B, Templier I, Troin L, Montaudié H, Ingen-Housz-Oro S, Faiz S, Mortier L, Dobos G, Bagot M, Resche-Rigon M, Montlahuc C, Serret-Larmande A, de Masson A. Real-life efficacy of immunotherapy for Sézary syndrome: a multicenter observational cohort study. EClinicalMedicine 2024; 73:102679. [PMID: 39007062 PMCID: PMC11245986 DOI: 10.1016/j.eclinm.2024.102679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 07/16/2024] Open
Abstract
Background Sézary syndrome is an extremely rare and fatal cutaneous T-cell lymphoma (CTCL). Mogamulizumab, an anti-CCR4 monoclonal antibody, has recently been associated with increased progression-free survival in a randomized clinical trial in CTCL. We aimed to evaluate OS and prognostic factors in Sézary syndrome, including treatment with mogamulizumab, in a real-life setting. Methods Data from patients with Sézary (ISCL/EORTC stage IV) and pre-Sézary (stage IIIB) syndrome diagnosed from 2000 to 2020 were obtained from 24 centers in Europe. Age, disease stage, plasma lactate dehydrogenases levels, blood eosinophilia at diagnosis, large-cell transformation and treatment received were analyzed in a multivariable Cox proportional hazard ratio model. This study has been registered in ClinicalTrials (SURPASSe01 study: NCT05206045). Findings Three hundred and thirty-nine patients were included (58% men, median age at diagnosis of 70 years, Q1-Q3, 61-79): 33 pre-Sézary (9.7% of 339), 296 Sézary syndrome (87.3%), of whom 10 (2.9%) had large-cell transformation. One hundred and ten patients received mogamulizumab. Median follow-up was 58 months (95% confidence interval [CI], 53-68). OS was 46.5% (95% CI, 40.6%-53.3%) at 5 years. Multivariable analysis showed that age ≥ 80 versus <50 (HR: 4.9, 95% CI, 2.1-11.2, p = 0.001), and large-cell transformation (HR: 2.8, 95% CI, 1.6-5.1, p = 0.001) were independent and significant factors associated with reduced OS. Mogamulizumab treatment was significantly associated with decreased mortality (HR: 0.34, 95% CI, 0.15-0.80, p = 0.013). Interpretation Treatment with mogamulizumab was significantly and independently associated with decreased mortality in Sézary syndrome. Funding French Society of Dermatology, Swiss National Science Foundation (IZLIZ3_200253/1) and SKINTEGRITY.CH collaborative research program.
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Affiliation(s)
- Alizée Bozonnat
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | - Marie Beylot-Barry
- Department of Dermatology, CHU de Bordeaux, BoRdeaux Institute of Oncology, BRIC INSERM U1312, INSERM BoRdeaux Institute of Oncology, Team 5, Université de Bordeaux, Bordeaux, France
| | - Olivier Dereure
- Department of Dermatology, University of Montpellier, Montpellier, France
| | - Michel D’Incan
- Department of Dermatology, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Gaëlle Quereux
- Department of Dermatology, Nantes University Hospital, CIC 1413, Inserm UMR 1302/EMR6001 INCIT, F-44000 Nantes, France
| | - Emmanuella Guenova
- Department of Dermatology, University Hospital Lausanne, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | | | - Stephane Dalle
- Department of Dermatology, Hospices Civils de Lyon, Lyon, France
| | | | - Manuelle-Anne Viguier
- Department of Dermatology, Université Reims-Champagne Ardenne, EA7509-IRMAIC, Reims, France
| | | | - Laurence Feldmeyer
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Helmut Beltraminelli
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nathalie Bonnet
- Department of Dermatology, CHU de Marseille, Marseille, France
| | - Florent Amatore
- Department of Dermatology, CHU de Marseille, Marseille, France
| | - Eve Maubec
- Department of Dermatology, Avicenne Hospital, AP-HP, Bobigny, France
| | | | | | - François Chasset
- Department of Dermatology, CHU Tenon, Faculty of Medicine, Sorbonne University, Paris, France
| | | | - Jean-David Bouaziz
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | - Maxime Battistella
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Pathology Laboratory, Saint-Louis Hospital, AP-HP, Paris, France
| | - Marie Donzel
- Pathology Laboratory, Hospices Civils de Lyon, Lyon, France
| | - Anne Pham-Ledard
- Department of Dermatology, CHU de Bordeaux, BoRdeaux Institute of Oncology, BRIC INSERM U1312, INSERM BoRdeaux Institute of Oncology, Team 5, Université de Bordeaux, Bordeaux, France
| | - Claudia Bejar
- Department of Dermatology, Avicenne Hospital, AP-HP, Bobigny, France
| | - Hélène Moins-Teisserenc
- Université Paris Cité, Paris, France
- Hematology Laboratory, Saint-Louis Hospital, AP-HP, Paris, France
| | - Samia Mourah
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Department of Pharmacogenomics and Oncogenetics, Saint-Louis Hospital, AP-HP, Paris, France
| | - Philippe Saiag
- Department of Dermatology, Ambroise-Paré Hospital, AP-HP, & EA 4340 “Biomarkers in Cancerology and Hemato-Oncology”, UVSQ, Université Paris-Saclay, 92104, Boulogne-Billancourt, France
| | - Ewa Hainaut
- Department of Dermatology, CHU de Poitiers, Poitiers, France
| | - Catherine Michel
- Department of Dermatology, CH Mulhouse, Groupe Hospitalier Mulhouse Sud Alsace, Mulhouse, France
| | - Guido Bens
- Department of Dermatology, CHU Orléans, Orléans, France
| | - Henri Adamski
- Department of Dermatology, CHU Pontchaillou, Rennes, France
| | - François Aubin
- Department of Dermatology, CHU de Besançon, Besançon, France
| | | | - Pascal Joly
- Department of Dermatology, CHU de Rouen, Rouen, France
| | | | | | - Laura Troin
- Department of Dermatology, CHU de Nice, Nice, France
| | | | | | - Sarah Faiz
- Department of Dermatology, CHU Lille, Lille, France
| | | | - Gabor Dobos
- Department of Dermatology, Charité Hospital, Berlin, Germany
| | - Martine Bagot
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | - Matthieu Resche-Rigon
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Department of Biostatistics, Saint-Louis Hospital, AP-HP, Paris, France
| | - Claire Montlahuc
- Department of Biostatistics, Saint-Louis Hospital, AP-HP, Paris, France
| | - Arnaud Serret-Larmande
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Department of Biostatistics, Saint-Louis Hospital, AP-HP, Paris, France
| | - Adèle de Masson
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | - Cutaneous Lymphomas French Study Group
- Department of Dermatology, Saint-Louis Hospital, AP-HP, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Department of Dermatology, CHU de Bordeaux, BoRdeaux Institute of Oncology, BRIC INSERM U1312, INSERM BoRdeaux Institute of Oncology, Team 5, Université de Bordeaux, Bordeaux, France
- Department of Dermatology, University of Montpellier, Montpellier, France
- Department of Dermatology, CHU de Clermont-Ferrand, Clermont-Ferrand, France
- Department of Dermatology, Nantes University Hospital, CIC 1413, Inserm UMR 1302/EMR6001 INCIT, F-44000 Nantes, France
- Department of Dermatology, University Hospital Lausanne, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Dermatology, Hospices Civils de Lyon, Lyon, France
- Department of Dermatology, CH de Valence, France
- Department of Dermatology, Université Reims-Champagne Ardenne, EA7509-IRMAIC, Reims, France
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Dermatology, CHU de Marseille, Marseille, France
- Department of Dermatology, Avicenne Hospital, AP-HP, Bobigny, France
- Department of Dermatology, CHU Cochin, Paris, France
- Department of Dermatology, CHU de Tours, Tours, France
- Department of Dermatology, CHU Tenon, Faculty of Medicine, Sorbonne University, Paris, France
- Department of Dermatology, CHU Bichat, Paris, France
- Pathology Laboratory, Saint-Louis Hospital, AP-HP, Paris, France
- Pathology Laboratory, Hospices Civils de Lyon, Lyon, France
- Hematology Laboratory, Saint-Louis Hospital, AP-HP, Paris, France
- Department of Pharmacogenomics and Oncogenetics, Saint-Louis Hospital, AP-HP, Paris, France
- Department of Dermatology, Ambroise-Paré Hospital, AP-HP, & EA 4340 “Biomarkers in Cancerology and Hemato-Oncology”, UVSQ, Université Paris-Saclay, 92104, Boulogne-Billancourt, France
- Department of Dermatology, CHU de Poitiers, Poitiers, France
- Department of Dermatology, CH Mulhouse, Groupe Hospitalier Mulhouse Sud Alsace, Mulhouse, France
- Department of Dermatology, CHU Orléans, Orléans, France
- Department of Dermatology, CHU Pontchaillou, Rennes, France
- Department of Dermatology, CHU de Besançon, Besançon, France
- Department of Dermatology, CHU de Toulouse, Toulouse, France
- Department of Dermatology, CHU de Rouen, Rouen, France
- Department of Dermatology, CHU de Grenoble, Grenoble, France
- Department of Dermatology, CHU de Nice, Nice, France
- Department of Dermatology, Henri Mondor Hospital, APHP, Créteil, France
- Department of Dermatology, CHU Lille, Lille, France
- Department of Dermatology, Charité Hospital, Berlin, Germany
- Department of Biostatistics, Saint-Louis Hospital, AP-HP, Paris, France
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