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Izu-Belloso R, Gainza-Apraiz I, Ortiz-Romero P, Servitje-Bedate O, Fernández de Misa-Cabrera R, Peñate-Santana Y, Hernandez-Machin B, Estrach-Panella T, Llamas-Velasco M, Yanguas-Bayona JI, Morillo-Andujar M, Acebo-Mariñas E, Perez-Gala S, Armario-Hita JC, Sanchez-Sambucety P, Ortiz-Brugues A, Eguren-Michelena C, Bielsa-Marsol I, Lopez-Pestaña A, Blanes-Martinez M, Fernandez-Guarino M, Lopez-Lerma I. Experience With Bexarotene to Treat Cutaneous T-Cell Lymphomas: A Study of the Spanish Working Group of Cutaneous Lymphomas. Actas Dermosifiliogr 2024:S0001-7310(24)00358-2. [PMID: 38653368 DOI: 10.1016/j.ad.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/04/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Bexarotene has been approved to treat advanced stage cutaneous T-cell lymphomas (CTCL) since 1999. However, very few data have been published on its long-term safety and efficacy profile. The aim of this study is to determine the tolerability to bexarotene and outcomes by collecting the 2nd largest case series to date on its long-term use vs CTCL. MATERIAL AND METHOD This was a multicenter retrospective review of 216 patients with mycosis fungoides (174), or Sézary syndrome (42) on a 10-year course of bexarotene alone or in combinationwith other therapies at 19 tertiary referral teaching hospitals. RESULTS A total of 133 men (62%) and 83 women (38%) were included, with a mean age of 63.5 year (27-95). A total of 45% were on bexarotene monotherapy for the entire study period, 22% started on bexarotene but eventually received an additional therapy, 13% were on another treatment but eventually received bexarotene while the remaining 20% received a combination therapy since the beginning. The median course of treatment was 20.78 months (1-114); and the overall response rate, 70.3%. Complete and partial response rates were achieved in 26% and 45% of the patients, respectively. Treatment was well tolerated, being the most common toxicities hypertriglyceridemia (79%), hypercholesterolemia (71%), and hypothyroidism (52%). No treatment-related grade 5 adverse events were reported. CONCLUSIONS Our study confirms bexarotene is a safe and effective therapy for the long-term treatment of CTCL.
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Affiliation(s)
| | | | | | | | | | - Y Peñate-Santana
- Hospital Universitario Basurto, Bilbao, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital de Bellvitge, Barcelona, Spain; Red Canaria de Linfomas, Spain; Hospital Clinic de Barcelona, Spain; Hospital La Princesa, Madrid, Spain; Complejo Hospitalario Navarra, Pamplona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Universitario Cruces, Barakaldo, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Universitario del Puerto Real, Cadiz, Spain; Hospital Universitario de León, Spain; Hospital Arnau y Vilanova, Lérida, Spain; Hospital Infanta Leonor, Madrid, Spain; Hospital German Trias y Pujol, Barcelona, Spain; Hospital Universitario Donostia, San Sebastián, Spain; Hospital de Alicante, Spain; Hospital Cruz Roja, Madrid, Spain; Hospital Vall D´Hebrón, Barcelona, Spain
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Izu-Belloso R, Gainza-Apraiz I, Ortiz-Romero P, Servitje-Bedate O, Fernández de Misa-Cabrera R, Peñate Y, Hernandez-Machin B, Estrach-Panella T, Llamas-Velasco M, Yanguas-Bayona JI, Morillo-Andujar M, Acebo-Mariñas E, Perez-Gala S, Armario-Hita JC, Sanchez-Sambucety P, Ortiz-Brugues A, Eguren-Michelena C, Bielsa-Marsol I, Lopez-Pestaña A, Blanes-Martinez M, Fernandez-Guarino M, Lopez-Lerma I. Experience With Bexarotene to Treat Cutaneous T-Cell Lymphomas: A Study of the Spanish Working Group of Cutaneous Lymphomas. Actas Dermosifiliogr 2024:S0001-7310(24)00160-1. [PMID: 38395224 DOI: 10.1016/j.ad.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Bexarotene has been approved to treat advanced stage cutaneous T-cell lymphomas (CTCL) since 1999. However, very few data have been published on its long-term safety and efficacy profile. The aim of this study is to determine the tolerability to bexarotene and outcomes by collecting the 2nd largest case series to date on its long-term use vs CTCL. MATERIAL AND METHOD This was a multicenter retrospective review of 216 patients with mycosis fungoides (174), or Sézary syndrome (42) on a 10-year course of bexarotene alone or in combination with other therapies at 19 tertiary referral teaching hospitals. RESULTS A total of 133 men (62%) and 83 women (38%) were included, with a mean age of 63.5 year (27-95). A total of 45% were on bexarotene monotherapy for the entire study period, 22% started on bexarotene but eventually received an additional therapy, 13% were on another treatment but eventually received bexarotene while the remaining 20% received a combination therapy since the beginning. The median course of treatment was 20.78 months (1-114); and the overall response rate, 70.3%. Complete and partial response rates were achieved in 26% and 45% of the patients, respectively. Treatment was well tolerated, being the most common toxicities hypertriglyceridemia (79%), hypercholesterolemia (71%), and hypothyroidism (52%). No treatment-related grade 5 adverse events were reported. CONCLUSIONS Our study confirms bexarotene is a safe and effective therapy for the long-term treatment of CTCL.
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Affiliation(s)
| | | | | | | | | | - Y Peñate
- Complejo Hospitalario Universitario Insular Materno-Infantil, Gran Canaria, Spain
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Ingen-Housz-Oro S, Elshot YS, Segura S, Marchand A, Pouessel D, Kluger N, de Barros Silva G, Ortiz-Brugues A, Aubert M, Saldana C, Mavroudis D, Burle E, Tournier E, Koumaki D, Sibaud V. Skin toxicity of enfortumab vedotin: Proposal of a specific management algorithm. J Eur Acad Dermatol Venereol 2024; 38:e99-e101. [PMID: 37607297 DOI: 10.1111/jdv.19454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/18/2023] [Indexed: 08/24/2023]
Affiliation(s)
- Saskia Ingen-Housz-Oro
- Dermatology Department, AP-HP, Henri Mondor Hospital, Univ Paris Est Créteil EpiDermE, Créteil, France
- Reference Center for Toxic Bullous Diseases and Severe Drug Reactions TOXIBUL, Créteil, France
- Dermatology for Cancer Patients EADV Task Force, Toulouse, France
| | - Yannick S Elshot
- Dermatology for Cancer Patients EADV Task Force, Toulouse, France
- Department of Dermatology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sonia Segura
- Dermatology for Cancer Patients EADV Task Force, Toulouse, France
- Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Pompeu Fabra, Barcelona, Spain
| | - Antoine Marchand
- Dermatology for Cancer Patients EADV Task Force, Toulouse, France
- Dermatology Unit, Department of Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Damien Pouessel
- Oncology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
| | - Nicolas Kluger
- Dermatology for Cancer Patients EADV Task Force, Toulouse, France
- Dermatology Department, Helsinki University Hospital, Helsinki, Finland
| | - Giselle de Barros Silva
- Dermatology for Cancer Patients EADV Task Force, Toulouse, France
- Dermatology Department, Hospital 12 de Octubre, Madrid, Spain
| | - Ariadna Ortiz-Brugues
- Dermatology for Cancer Patients EADV Task Force, Toulouse, France
- Oncology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
| | - Marine Aubert
- Oncology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Carolina Saldana
- Oncology Department, AP-HP, Henri Mondor Hospital, Créteil, France
- Univ Paris Est Creteil, TRePCa, Créteil, France
| | - Dimitrios Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Estelle Burle
- Oncology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
| | - Emilie Tournier
- Department of Pathology, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
| | - Dimitra Koumaki
- Dermatology for Cancer Patients EADV Task Force, Toulouse, France
- Department of Dermatology and Venereology, University Hospital of Heraklion, Crete, Greece
| | - Vincent Sibaud
- Dermatology for Cancer Patients EADV Task Force, Toulouse, France
- Oncology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
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Cabello I, Alia P, Pintó X, Muniesa C, Fernandez-de-Misa R, Peñate Y, Morillo M, Perez-Farriols A, Estrach T, Izu R, Gallardo F, Román C, Cervigón I, Ortiz-Brugues A, Ortiz-Romero PL, Servitje O. Association of APOA5 and APOC3 Genetic Polymorphisms With Severity of Hypertriglyceridemia in Patients With Cutaneous T-Cell Lymphoma Treated With Bexarotene. JAMA Dermatol 2019; 154:1424-1431. [PMID: 30422238 DOI: 10.1001/jamadermatol.2018.3679] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Hypertriglyceridemia is the most frequent and limiting adverse effect of bexarotene therapy in cutaneous T-cell lymphoma (CTCL). Despite standard prophylactic measures, there is a wide variability in the severity of this complication, which could be associated with both genetic and environmental factors. Objectives To analyze the association between genetic polymorphisms of apolipoprotein genes APOA5, APOC3, and APOE and the severity of hypertriglyceridemia during bexarotene therapy and to optimize patient selection for bexarotene therapy based on adverse effect profile. Design, Setting, and Participants This case series study was conducted in 12 university referral hospitals in Spain from September 17, 2014, to February 6, 2015. One hundred twenty-five patients with a confirmed diagnosis of CTCL who had received bexarotene therapy for at least 3 months were enrolled. Nine patients were excluded owing to missing analytic triglyceride level data, leaving a study group of 116 patients. Data on demographic and cardiovascular risk factor were collected, and a complete blood analysis, including lipid profile and genetic analysis from a saliva sample, was performed. Main Outcomes and Measures Primary outcomes were the maximal triglyceride levels reported in association with the minor alleles of the polymorphisms studied. Results Among 116 patients, the mean (SD) age was 61.2 (14.7) years, 69 (59.5%) were men, and 85 (73.2%) had mycosis fungoides, the most prevalent form of CTCL. During bexarotene therapy, 96 patients (82.7%) experienced hypertriglyceridemia, which was severe or extreme in 8 of these patients (8.3%). Patients who carried minor alleles of the polymorphisms did not show significant differences in baseline triglyceride concentrations. After bexarotene treatment, carriers of at least 1 of the 2 minor alleles of APOA5 c.-1131T>C and APOC3 c.*40C>G showed lower levels of triglycerides than noncarriers (mean [SD], 241.59 [169.91] vs 330.97 [169.03] mg/dL, respectively; P = .02). Conclusions and Relevance These results indicate that the screening of APOA5 and APOC3 genotypes may be useful to estimate changes in triglyceride concentrations during bexarotene treatment in patients with CTCL and also to identify the best candidates for bexarotene therapy based on the expected adverse effect profile.
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Affiliation(s)
- Irene Cabello
- Cardiovascular Risk Unit, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - Pedro Alia
- Clinical Genetics Laboratory, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - Xavier Pintó
- Cardiovascular Risk Unit, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - Cristina Muniesa
- Dermatology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - Ricardo Fernandez-de-Misa
- Dermatology Department, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - Yerai Peñate
- Dermatology Department, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
| | - Mercedes Morillo
- Dermatology Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | | | - Teresa Estrach
- Dermatology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Rosa Izu
- Dermatology Department, Hospital Universitario de Basurto, Bilbao, Spain
| | | | - Concepción Román
- Dermatology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Iván Cervigón
- Dermatology Department, Hospital Nuestra Señora del Prado, Talavera, Spain
| | | | - Pablo L Ortiz-Romero
- Dermatology Department, Hospital Universitario 12 de Octubre, Institute i+12, CIBERONC, Medical School, University Complutense, Madrid, Spain
| | - Octavio Servitje
- Dermatology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
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