15-ICML: Post Hoc Analysis of MAVORIC Study: Mogamulizumab in Patients With Previously Treated Cutaneous T-Cell Lymphoma
The MAVORIC study—presented by Scarisbrick et al at the 15th International Conference on Malignant Lymphoma (ICML; Abstract 034)—examined the efficacy of mogamulizumab, a monoclonal antibody that targets the CC chemokine receptor 4 (CCR4), in patients with previously treated mycosis fungoides/Sezary syndrome, the most common form of cutaneous T-cell lymphoma.
Background of MAVORIC
Data from MAVORIC were previously published by Kim et al in The Lancet Oncology. This earlier report found that patients with previously treated stage IB-IVB mycosis fungoides treated with mogamulizumab experienced longer progression-free survival (7.7 vs 3.1 months) vs patients treated with vorinostat. These findings led to U.S. regulatory approval of mogamulizumab in this setting.
Data presented at ICML was based on a post hoc analysis that specifically examined the efficacy and safety of mogamulizumab in patients with stage IB and IIA mycosis fungoides.
Methods
In MAVORIC, 372 patients with stage IB–IVB mycosis fungoides treated with at least one prior systemic therapy were randomly assigned to receive mogamulizumab or vorinostat. In the post hoc analysis, time to next treatment was defined as time to any therapy, excluding topical steroids or focal radiotherapy.
Overall response rate was based on global composite response in four disease compartments—skin, blood, lymph nodes, and viscera achieved at two consecutive clinical visits at least 8 weeks apart. However, individual compartment responses were also assessed.
Post Hoc Analysis Results
A total of 85 patients with stage IB and IIA disease were included in the post hoc analysis. Overall, 79% of patients with stage IB disease and 84% of patients with stage IIA disease had received two or more prior systemic therapies, and 24% of patients with stage IB disease and 28% of patients with stage IIA disease had received six or more prior systemic therapies.
Median time to next therapy in patients with stage IB disease treated with mogamulizumab was 11.5 months (95% confidence interval [CI] = 1.4–16.0) vs 3 months in patients treated with vorinostat (95% CI = 2.7–5.3). In patients with stage IIA disease, median time to next therapy was 10.1 months in those treated with mogamulizumab (95% CI = 5.5–12.6) vs 4.9 months in those treated with vorinostat (95% CI = 2.4–8.0).
Overall response rate was 20% in stage IB patients treated with mogamulizumab vs 18.5% in those treated with vorinostat. In stage IIA patients, overall response rate was 19% vs 0%, respectively.
Compartmental response rates seen with mogamulizumab were:
- Skin: 20% stage IB, 38% stage IIA
- Blood: 0% stage IB, 75% stage IIA
- Lymph node: 0% stage IB, 15% stage IIA.
The authors concluded, “This post hoc analysis of time to next therapy, overall response rate, and compartmental response in stage IB/IIA demonstrates meaningful clinical benefit with mogamulizumab in early-stage [patients with mycosis fungoides] previously treated with systemic therapies, despite MAVORIC not being powered to determine treatment effect by disease stage.”
Disclosure: For full disclosures of the study authors, visit lymphcon.ch.
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