Recommendations for treatment of MF stage IIB
| Treatment . | Comments* . |
|---|---|
| First-line | |
| IFN-α | Can be effective even in patients with tumor and/or ulcerated lesions; see Table 7 for other comments; IFN-α can also be combined with PUVA, retinoids, bexarotene, MTX |
| TSEB and superficial X-irradiation | “Boosts” needed to site of thickened plaques/tumors; limited availability; can take 6 to 10 weeks to complete |
| PUVA | For patch/plaque disease; requires regular 2 or 3 times/week treatment; there may be limited availability of PUVA in nonmetropolitan areas; can be combined with retinoids/rexinoids, bexarotene, IFN-α |
| Second-line | |
| Bexarotene | See Table 7 for comments |
| Vorinostat | See Table 7 for comments |
| Denileukin diftitox | See Table 7 for comments |
| Novel agents within clinical trials | In patients with stage IIB disease, chemotherapy is recommended after bexarotene and/or and HDACi and/or DD; it is very acceptable to consider novel agents within clinical trials before chemotherapy is considered (see Table 12) |
| Chemotherapy | Choice of chemotherapy regimens is extensive (see Table 11), and choice depends on patient tolerance, risk of infection versus the relatively short duration of remission observed with most chemotherapy regimens; transplantation may be considered in highly selected persons |
| Treatment . | Comments* . |
|---|---|
| First-line | |
| IFN-α | Can be effective even in patients with tumor and/or ulcerated lesions; see Table 7 for other comments; IFN-α can also be combined with PUVA, retinoids, bexarotene, MTX |
| TSEB and superficial X-irradiation | “Boosts” needed to site of thickened plaques/tumors; limited availability; can take 6 to 10 weeks to complete |
| PUVA | For patch/plaque disease; requires regular 2 or 3 times/week treatment; there may be limited availability of PUVA in nonmetropolitan areas; can be combined with retinoids/rexinoids, bexarotene, IFN-α |
| Second-line | |
| Bexarotene | See Table 7 for comments |
| Vorinostat | See Table 7 for comments |
| Denileukin diftitox | See Table 7 for comments |
| Novel agents within clinical trials | In patients with stage IIB disease, chemotherapy is recommended after bexarotene and/or and HDACi and/or DD; it is very acceptable to consider novel agents within clinical trials before chemotherapy is considered (see Table 12) |
| Chemotherapy | Choice of chemotherapy regimens is extensive (see Table 11), and choice depends on patient tolerance, risk of infection versus the relatively short duration of remission observed with most chemotherapy regimens; transplantation may be considered in highly selected persons |
For more details and detailed references, we refer the reader to the EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome.7