Christiane Querfeld, MD, PhD, dermatologist and and Director, Multidisciplinary Cutaneous Lymphoma Program, Professor at the City of Hope National Medical Center and the Beckman Research Institute, discusses the results of a new drug trial that increased the dosing interval of mogamulizumab in patients with CTCL.
Currently, treatment with the oncolytic agent mogamulizumab-kpkc (Poteligeo) in patients with Sézary syndrome and mycosis fungoides, which is collectively called cutaneous T-cell lymphoma (CTCL), consists of weekly infusions during the first month of therapy, followed by double doses administered twice monthly. A new trial, called the MOGA-2 mg q4w study, sought to evaluate the effectiveness and safety of mogamulizumab given by weekly infusions for the first month, followed by once monthly injections of 2-mg doses, for each subsequent month.
Another aspect of the study is to gather data around the appearance of a rash that is associated with mogamulizumab use. This seems to be an indication of an “immune flare,” which varies in severity by patient but can be debilitated in those most affected. Dr. Querfeld pointed out that the rash is more common in patients who respond to mogamulizumab therapy than those with do not.
By reducing the number of infusions, this may improve patient’s quality of life and lessen the transportation burden on patients and their caregivers. The key, according to Dr. Querfeld, is using the data obtained from the study to determine if certain subgroups of patients respond favorably to this regimen. She hopes these cohorts may be identified by their gene signatures, or classifications of variants in multiple genes.
Currently, 65 gene mutations have been identified as drivers of CTCL. The trial found that patients who responded well to the modified mogamulizumab regimen had more mutations compared with nonresponders.
It is thus critical for any diagnosed patient to have their skin biopsied and evaluated on a molecular level, identifying gene mutations, and especially CCR4 status. It will allow patients earlier access to personalized, targeted medicine, and perhaps optimally effective treatment.
To learn more about CTCL, visit https://checkrare.com/cutaneous-t-cell-lymphoma-2/