Pembrolizumab Shows Promise in Two CTCL Subtypes

TOPLINE:

Pembrolizumab demonstrated clinical activity in patients with mycosis fungoides (MF) and Sézary syndrome (SS), the most common subtypes of cutaneous T-cell lymphoma (CTCL), with nearly half of treated patients achieving a response in a case series.

METHODOLOGY:

• Researchers conducted a retrospective analysis of 30 patients (median age, 68 years; 56.7% women) with MF and SS who received pembrolizumab at the University of Pennsylvania, Philadelphia, between December 2017 and December 2023.
• Most patients (90%) received pembrolizumab on a schedule of 200 mg every 3 weeks. The median number of prior systemic therapies was 3, and the median treatment duration was 4.5 months. Concurrent treatments included liposomal doxorubicin, interferon alpha, and radiation therapy.
• Outcomes assessed were treatment responses and immune-related adverse events.
• The median follow-up was 20.4 months.

TAKEAWAY:

• The overall response rate was evaluable in 27 patients; of those patients, 14 (48%) had a global response, with 5 complete and 9 partial responses. The median duration of response was 13.1 months.
• Response rates varied by disease stage and compartment; 7 of 9 patients with early-stage disease (stage I-IIA) and 7 of 20 with late-stage disease (stage IIB-IV) achieved responses. The highest response was observed in the skin (55%), followed by nodes (54%), viscera (50%), and blood (44%).
• The median progression-free survival was 7.4 months, and the median overall survival was 20.6 months.
• Immune-related adverse events occurred in 43% of patients, primarily grade 1 or 2 (85%). The most common were dermatologic (38%), endocrine (31%), and gastrointestinal (23%) toxicities.

IN PRACTICE:

“These results suggest that pembrolizumab has therapeutic value for MF/SS,” the authors wrote. “Future prospective clinical trials are warranted to assess combination approaches and predictive biomarkers in patients with CTCL receiving pembrolizumab,” they added.

SOURCE:

The study was led by Omar Elghawy, MD, Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia. It was published online on April 2 in JAMA Dermatology.

LIMITATIONS:

Study limitations were heterogeneous disease characteristics among patients, assessment intervals, prior treatment, and concurrent treatments.

DISCLOSURES:

The authors did not disclose any funding source. Several authors reported receiving grants and personal fees outside this work from various companies, including Adaptive, AstraZeneca, BMS, Incyte, Kite, Seagen, and Merck. One author was principal investigator of a study where Merck provided pembrolizumab plus radiation therapy outside the submitted work. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.