P046 | CLINICAL OUTCOMES OF TARGETED MONOCLONAL ANTIBODIES IN REFRACTORY CUTANEOUS T-CELL LYMPHOMAS: A REAL-WORLD SINGLE-CENTER RETROSPECTIVE OVERVIEW

Cutaneous T-cell lymphomas (CTCLs) are rare non-Hodgkin lymphomas, with mycosis fungoides (MF) and Sézary syndrome (SS) representing the most common advanced-stage subtypes. Targeted therapies include mogamulizumab (MOGA), a CCR4-targeting monoclonal antibody, and brentuximab vedotin (BV), a CD30-directed antibody-drug conjugate. The MAVORIC trial compared MOGA with vorinostat in relapsed/refractory MF and SS patients, regardless of CD30 expression. The ALCANZA trial compared BV with methotrexate or bexarotene in CD30-positive MF or primary cutaneous anaplastic large cell lymphoma. Due to differing inclusion criteria, direct comparisons between MOGA and BV remain limited. Therefore, we conducted a retrospective analysis of clinical outcomes in advanced CTCL patients treated at our center. We included 18 patients with MF (n=13, 72.2%) and SS (n=5, 27.8%) treated between January 2018 and March 2025. Thirteen pts (72.2%) were male. Ten pts received MOGA (6 with MF, 4 with SS) and eight pts BV (7 with MF, 1 with SS). Median age at treatment initiation was 73 years (range 54–84) with MOGA and 73 years (range 53–75) with BV. The median number of prior systemic therapies was 3 for MOGA and 5 for BV. At baseline, 4 pts had localized-stage disease (stage IIA or lower) (2 treated with MOGA, 2 BV), and 14 had advanced-stage disease (stage IIB or higher) (8 treated with MOGA, 6 with BV). In 3 pts, lymph node involvement was demonstrated; no extranodal disease beyond the skin was observed. CD30 expression was assessed in 12 patients: CD30 was expressed in 100% of MF pts and 50% of SS pts. Peripheral blood involvement was evaluated by flow cytometry in 13 patients. Among MOGA-treated patients, 1 had B0, 4 had B1, and 3 had B2 stage; among BV-treated 4 had B1, and 1 had B2. The overall response rate was 80% with MOGA (20% CR, 60% PR) and 75% with BV (25% CR, 50% PR) (p = 0.632). Median treatment duration was 7 months with MOGA and 7 months with BV. Mogamulizumab-associated rash (MAR) occurred in 3 pts, while grade >1 neuropathy occurred in 1 pts treated with BV, without requiring dose reduction. In this real-world experience, both mogamulizumab and brentuximab vedotin were effective and well-tolerated in advanced CTCL. Limitations include the retrospective design and small sample size. These findings highlight the importance of personalized and combination strategies to optimize outcomes in this challenging disease.