(1) Background: Most patients with mycosis fungoides (MF), a form of cutaneous T-cell lymphoma (CTCL), develop relapsed/refractory (R/R) disease following front-line systemic therapy. This report describes treatment patterns and outcomes from the subpopulation with R/R MF. (2) Methods: This observational, retrospective, cohort study analyzed patient records (1984–2016) from 27 clinical sites in Europe. Outcomes included treatments received, response to first-, second- and third-line treatment, overall survival (OS) and progression-free survival (PFS). (3) Results: Of 104 patients with MF, 100 received second-line and 61 received third-line therapy. The median (range) times from the start of first-line therapy to the first R/R MF and from the first to the second R/R MF were 11.2 (0.3–166.5) and 13.5 (0.0–174.6) months, respectively. Second-and third-line treatment options varied and comprised systemic therapies (85% and 79% of patients, respectively), radiotherapy (32% and 34%, respectively) and topical therapies (48% and 36%, respectively). The median (95% confidence interval [CI]) OS from the diagnosis of the first R/R MF was 11.5 (6.5–not reached [NR]) years and was higher with non-chemotherapy (NR) versus chemotherapy (6.5 years); the estimated median PFS (95% CI) from the time of the first R/R MF was 1.3 (1.0–2.1) years. (4) Conclusions: High rates of R/R disease were observed after second- and third-line treatments in this real-world cohort, with longer median OS in patients receiving non-chemotherapy treatment versus chemotherapy. Following the standard management of MF and using recently approved targeted therapies can help improve patient outcomes in advanced-stage MF.
(1) 背景：蕈样肉芽肿作为皮肤T细胞淋巴瘤的一种亚型，多数患者在接受一线系统治疗后会出现复发/难治性病情。本报告旨在描述复发/难治性蕈样肉芽肿亚群的治疗模式及临床结局。(2) 方法：这项观察性、回顾性队列研究分析了欧洲27个临床中心1984年至2016年间的患者病历资料。研究终点包括治疗方案选择、一线至三线治疗应答情况、总生存期及无进展生存期。(3) 结果：在104例蕈样肉芽肿患者中，接受二线治疗者100例，接受三线治疗者61例。从一线治疗开始至首次复发/难治的中位时间（范围）为11.2（0.3-166.5）个月，首次至第二次复发/难治的中位时间（范围）为13.5（0.0-174.6）个月。二线及三线治疗方案呈现多样性，包括系统治疗（分别占85%和79%）、放射治疗（分别占32%和34%）及局部治疗（分别占48%和36%）。自首次复发/难治诊断起的中位总生存期（95%置信区间）为11.5（6.5-未达到）年，其中非化疗方案组（未达到）显著优于化疗方案组（6.5年）；首次复发/难治后的中位无进展生存期（95%置信区间）估计值为1.3（1.0-2.1）年。(4) 结论：本真实世界队列研究显示，蕈样肉芽肿患者在二线及三线治疗后仍存在较高的复发/难治率，但接受非化疗方案治疗的患者中位总生存期显著优于化疗方案组。遵循蕈样肉芽肿标准治疗路径并应用新型靶向疗法，将有助于改善晚期蕈样肉芽肿患者的临床结局。
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