Romidepsin and mogamulizumab sequential treatment for advanced cutaneous T-cell lymphoma

Management of advanced stage cutaneous T-cell lymphoma (CTCL) can be challenging due to lack of durable responses to currently available therapies and their side effects and toxicities. Romidepsin, a histone deacetylase inhibitor, and mogamulizumab, an anti-CCR4 monoclonal antibody, have demonstrated some efficacy as monotherapies, however, survival outcomes remain poor. This retrospective study evaluates the effectiveness of sequential romidepsin-mogamulizumab (Romi-Moga) therapy in 18 patients with advanced CTCL. The overall response rate was 67% in our cohort and time to next treatment was 15 months, which compared favorably to clinical trials of monotherapies. Patients who transitioned to mogamulizumab within one month of romidepsin discontinuation exhibited superior responses in skin, blood, and lymph nodes and longer time to next treatment. These findings suggest a potential beneficial effect of Romi-Moga therapy when administered in close sequence. Prospective studies are needed to validate these results and optimize treatment strategies.