MedWire News: Patients with advanced or refractory cutaneous T-cell lymphoma (CTCL) respond well to pegylated liposomal doxorubicin, including those with Sézary syndrome or transformed CTCL who typically have a poor prognosis, say French researchers.
Brigitte Dreno (Centre Hospitalier Universitaire Hotel Dieu, Nantes) and colleagues conducted a multicenter study to investigate the objective response to pegylated liposomal doxorubicin in 25 patients.
Patients had either stage II to IV CTCL that had not responded to at least two lines of treatment or histologically transformed epidermotropic CTCL requiring chemotherapy.
Pegylated liposomal doxorubicin was administered at 40 mg/m2, once every 4 weeks, and patients received eight treatment cycles unless they had progressed after the first two cycles or were in complete remission after the fourth cycle.
Overall, 14 (56%) patients achieved an objective response at the end of treatment, including five complete responses and nine partial responses. The median overall survival was 43.7 months.
Of the five patients who achieved complete response, three (60%) relapsed after a median of 358 days.
The median progression-free survival after the end of treatment among the 14 patients who achieved at least a partial response was 5 months and the median overall survival was 45.8 months.
Of the 10 patients with Sézary syndrome, six (60%) patients achieved an objective response at the end of treatment, including one complete response and five partial responses.
Five (50%) of 10 patients with transformed CTCL achieved an objective response, including one patient who achieved a complete response and was still disease-free after 3 years.
The most common adverse events were anemia (36%), asthenia (20%), nausea and vomiting (20%), palmoplantar erythrodysesthesia (12%), neutropenia (12%), and stomach pain (12%). No episodes of febrile neutropenia were reported.
The researchers noted that there was a higher rate of adverse events in their study, compared with previous studies that evaluated pegylated liposomal doxorubicin at a dose of 20 mg/m2, especially hematologic toxicity.
"This study shows that if the dose is increased to 40 mg/m2, effectiveness is not improved, but toxic effects are increased compared with the dose of 20 mg/m2," Dreno and team write in the Archives of Dermatology.
They conclude: "Pegylated liposomal doxorubicin can be one of the choices in the treatment of CTCL."
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