Experience With Bexarotene to Treat Cutaneous T-Cell Lymphomas: A Study of the Spanish Working Group of Cutaneous Lymphomas

• Published in: Actas dermo-sifiliográficas 2024-06, Vol.115 (6), p.547-554
• Main Authors: 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, J.I., Morillo-Andujar, M., Acebo-Mariñas, E., Perez-Gala, S., Armario-Hita, J.C., Sanchez-Sambucety, P., Ortiz-Brugues, A., Eguren-Michelena, C., Bielsa-Marsol, I., Lopez-Pestaña, A., Blanes-Martinez, M., Fernandez-Guarino, M., Lopez-Lerma, I.
• Format: Article
• Language: English
• Subjects: Bexarotene; Bexaroteno; Cutaneous T-cell lymphoma; Linfoma cutáneo de células T; Micosis fungoide; Mycosis fungoides; Retinoid; Retinoide; Sézary syndrome; Síndrome de Sézary
• ISSN: 0001-7310; 1578-2190; 1578-2190; 2173-5778
• DOI: 10.1016/j.ad.2023.12.007

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. 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. 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. Our study confirms bexarotene is a safe and effective therapy for the long-term treatment of CTCL. El bexaroteno está aprobado para el tratamiento de linfomas cutáneos de células T (LCCT) en estadio avanzado desde 1999. Sin embargo, se han publicado muy pocos datos sobre su seguridad y eficacia en el largo plazo. El objetivo del siguiente trabajo es determinar la eficacia y seguridad del bexaroteno en la serie de casos del Grupo Español de Linfomas Cutáneos (GELC) en su uso a largo plazo para el tratamiento de CTCL. Realizamos una revisión retrospectiva multicéntrica de 216 pacientes con micosis fungoide (174) o síndrome de Sézary (42) tratados con bexaroteno solo o en combinación con otras terapias en 19 hospitales universitarios de referencia en España durante 10 años. Se incluyeron 133 hombres (62%) y 83 mujeres (38%), con una edad media de 63,5 años (27-95). El 45% recibió monoterapia con bexaroteno durante todo el período de estudio, el 22% comenzó con bexaroteno pero posteriormente recibió una terapia adicional, el 13% estaba bajo otro tratamiento pero en algún momento se añadió bexaroteno y el 20% restante r