Treatment of early-stage mycosis fungoides with oral bexarotene and phototherapy: A systematic review and meta-analysis.

Journal: Dermatologic Therapy
Treatment Used: Oral Bexarotene and Phototherapy
Number of Patients: 143
MediFind Summary

Overview: The study researched the use of oral bexarotene and phototherapy for treating early-stage mycosis fungoides.

Conclusion: Oral bexarotene and phototherapy may be beneficial for treating early-stage mycosis fungoides.

Abstract

Background: Mycosis fungoides (MF) is a rare subtype of non-Hodgkin lymphoma, for which no standard treatment exists.

Objective: To provide evidence-based recommendations for adult patients with early-stage MF treated with oral bexarotene and phototherapy.

Methods: A systematic review and meta-analysis was conducted utilizing studies identified via Embase, Pubmed, Web of Science, and the Cochrane Library from inception to April 2020 to evaluate the clinical efficacy and adverse events of oral bexarotene and phototherapy.

Results: Of 645 abstracts retrieved, 17 full-text articles with 143 subjects were included for analysis. There were nine case reports, five retrospective cohort studies, two prospective cohort studies, and one randomized controlled trial. Most subjects were men (24.48%) with stage IB disease (54.4%), and the mean age at presentation was 63. One patient had folliculotropic disease. The retrospective studies' analysis included 67 subjects and indicated that the partial response was 40.36% (95% CI 18.24 to 64.92), complete response was 34.06% (95% CI 10.73 to 62.56), and overall response was 64.48% (95% CI 48.56 to 78.89). Side effects from bexarotene were hypertriglyceridemia (54%), hypothyroidism (50%), and hypercholesterolemia (46%). Similar results were noted in the prospective studies.

Conclusions: The literature consists mostly of uncontrolled studies which suggest that combination therapy with oral bexarotene and phototherapy is a therapeutic option. Future randomized control studies with longer follow-up and standardized definitions of treatment responses and dosages are needed to support the development of evidence-based approaches for the treatment of early-stage MF. This article is protected by copyright. All rights reserved.

Authors
Erica Ginsburg, Kerry Hennessy, Rahul Mhaskar, Lucia Seminario Vidal

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