PCN144 Real-World Treatment Patterns Among Patients with Mycosis Fungoides or Sezary Syndrome in the United States

Abstract

Cutaneous T-cell lymphomas (CTCL) are rare, but can have serious and potentially life-threatening impact. The two most common subtypes are mycosis fungoides (MF) and the most aggressive type, Sézary syndrome (SS). Due to the very low prevalence, no study has analyzed the real-world treatment patterns of currently available therapies in MF or SS. This study aimed to examine real-world treatment utilization for patients with MF/SS in the United States in 2019 using a large claims database. Patients with ≥1 diagnosis code for MF or SS from the 2019 Symphony Health database were identified. Patients were classified into two cohorts: MF and SS. Patient characteristics and treatment patterns were analyzed. All MF or SS treatments recommended by the National Comprehensive Cancer Network guidelines were examined: skin-directed therapy (SDT, including topical, local radiation, or phototherapy), systemic therapy (injectable or oral), chemotherapy, and bone marrow transplant. Overall, 10,037 MF and 877 SS patients were identified (mean age: 63 and 67 years; >65 years: 56% and 65%; male: 54% and 55%, respectively). In MF, 60% of the patients had treatment claims: 56% with SDT, and 13% with systemic therapy (6% with injectables). Among MF patients treated with injectable systemic therapy, the most common were brentuximab vedotin (31%, 2017 MF approval), romidepsin (15%, 2009 CTCL approval), and mogamulizumab (14%, 2018 MF/SS approval). In SS, 72% of the patients had treatment claims: 56% with SDT, and 47% with systemic therapy (37% with injectables). Among SS patients treated with injectable systemic therapy, the most common were extracorporeal photopheresis (40%), mogamulizumab (31%), and romidepsin (18%). Claims analysis from 2019 found the majority of MF/SS patients used SDT, and approximately 50% of SS patients used systemic therapy. Mogamulizumab and romidepsin were among the most common injectable systemic treatments in both MF or SS patients.