Systemic Targeted Therapies in Patients with Relapsed/Refractory Advanced Stage Cutaneous T-cell Lymphoma: A Real-world Single-centre Case Series

Cutaneous T-cell lymphomas are a heterogeneous group of non-Hodgkin lymphomas. Early stages are often controlled with skin-directed therapy, such as topical corticosteroids, topical chlormethine gel, or UV therapy, whereas advanced stages often warrant a more aggressive approach with systemic antibody targeted therapy including mogamulizumab, brentuximab vedotin, or alemtuzumab. A retrospective cohort case series of 27 patients from Aarhus University Hospital, Denmark is presented, evaluating real-world outcomes of patients with cutaneous T-cell lymphomas treated with intravenous systemic targeted therapies from 2013 to 2023. The median age was 72 and the majority had Sézary syndrome or mycosis fungoides. All patients had relapsed/refractory advanced stage cutaneous T-cell lymphoma. Six patients received mogamulizumab, 12 patients received brentuximab vedotin, and 15 patients received alemtuzumab. Six patients received more than 1 of the systemic targeted treatments. Overall response rates were 78% for mogamulizumab, 65% for brentuximab vedotin, and 61% for alemtuzumab. Median time to progression was 2.5, 4, and 11 months, respectively. In conclusion, this paper offers a unique perspective on the complexities of clinical practice when managing advanced-stage cutaneous T-cell lymphomas and demonstrates the effectiveness of the therapies described, with particular emphasis on the promising results observed with alemtuzumab administered in a low-dose protocol.