Real world data shows that Chlormethine gel is efficient and safe in mycosis fungoides skin lesions
Oral presentation
Marios Koumourtzis
(2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, “Attikon” University General Hospital, Athens | Department of Dermatology and Venereology, University of Athens Medical School, Andreas Syggros Hospital, Athens | 2nd Dermatology Department, Aristotle University, Faculty of Medicine, Papageorgiou General Hospital, Thessaloniki | Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, Athens)
Background
Chlormethine gel is a skin-directed therapy used for patients with mycosis fungoides (MF) that has shown promising results in a randomized clinical trial. Currently, data on chlormethine gel use in real-world settings is limited.
Objectives
To assess safety and efficacy of chlormethine gel treatment in patients treated during daily clinical practice, and investigate associations between response and disease stage, lesion type, mono- or combination therapy, and occurrence of dermatitis.
Methods
A retrospective chart review of patients using chlormethine gel from 3 sites in Greece was performed. Efficacy was assessed through modified Severity-Weighted Assessment Tool (mSWAT) scores. Safety assessments included analysis of the occurrence and severity of dermatitis. The Skindex-29 questionnaire was used to evaluate quality of life.
Results
A total of 58 patients were included. The overall response rate (ORR) increased from 37.9% at month 1 to 80.8% at month 9. For 64.2% of patients, response was maintained for at least 4 months (ORR4). At month 3, a higher ORR was seen for patients with patches (69.7%) than patients with plaques/tumors (both 15.2%). A higher ORR4 was observed for patients with early-stage vs late-stage disease (71.4% vs 36.4%) and patients on mono- vs combination therapy (75% vs 47.6%). Dermatitis was observed in the majority of patients (72.4%), but the presence or severity of dermatitis was not directly correlated with treatment response. Both mSWAT and Skindex-29 scores decreased significantly during treatment, and changes in these scores from baseline to month 6 showed a positive correlation (r=0.55, p=0.026).
Conclusions
Chlormethine gel treatment was effective for patients with all stages of MF in clinical practice, although patients with patch-stage or early-stage disease may have higher response rates or more durable responses compared with patients with more-advanced disease. Response rates increased over time, indicating that continued treatment with the gel is important. Dermatitis may be managed by reducing the treatment frequency, and the occurrence of dermatitis did not affect the response to CL gel treatment.