Comparative outcomes following treatment with mogamulizumab versus brentuximab vedotin for mycosis fungoides or Sézary syndrome
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Presented at: Society for Investigative Dermatology 2025
Date: 2025-05-07 00:00:00
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Summary: Mogamulizumab, an anti-CCR4 monoclonal antibody, and brentuximab vedotin, an antibody-drug conjugate targeting CD30, are targeted immunotherapies for mycosis fungoides (MF) and Sezary syndrome (SS), but evidence for choosing between them is limited. We assessed safety outcomes among patients treated with either drug by conducting a retrospective cohort study with TriNetX, a multicenter database. Patients diagnosed with MF or SS between August 2018 and August 2024 within 6 months of starting either mogamulizumab or brentuximab vedotin were included. We performed propensity score matching (PSM) for demographics, comorbidities, and prior MF/SS-targeted treatments. Hazard ratios (HRs) were calculated using Cox proportional hazards regression. After PSM, 153 patients received mogamulizumab, while 153 were treated with brentuximab vedotin. Mogamulizumab was linked to a lower two-year risk of hospitalization (HR, 0.56; 95% CI, 0.38-0.83; <i>P</i>=.008), neutropenia (HR, 0.53; 95% CI, 0.36-0.77; <i>P</i>=.006), sepsis (HR, 0.44; 95% CI, 0.25-0.79; <i>P</i>=.009), acute lower respiratory infections (HR, 0.39; 95% CI, 0.20-0.77; <i>P</i>=.009), major adverse cardiovascular events (HR, 0.31; 95% CI, 0.15-0.66; <i>P</i>=.006), and drug-induced peripheral neuropathy (HR, 0.26; 95% CI, 0.11-0.61; <i>P</i>=.006). However, there was an increased risk of lymphopenia (HR, 1.50; 95% CI, 1.14-1.97; <i>P</i>=.008) and dermatitis (HR, 1.65; 95% CI 1.09-2.50; <i>P</i>=.03) with mogamulizumab. Our data suggest a reduced risk of hospitalization and serious adverse events in MF/SS patients treated with mogamulizumab compared to brentuximab vedotin, possibly related to off-target effects associated with the cytotoxic agent in brentuximab vedotin. Bryan L. Peacker<sup>1, 2</sup>, Natalie Braun<sup>1, 2</sup>, Natalie Baker<sup>1, 2</sup>, Ghida El-Banna<sup>2</sup>, Salvia Jain<sup>1, 3, 4</sup>, Kevin Ma<sup>2</sup>, Steven Chen<sup>1, 2</sup> 1. Harvard Medical School, Boston, MA, United States. 2. Massachusetts General Hospital, Boston, MA, United States. 3. Massachusetts General Hospital Cancer Center, Boston, MA, United States. 4. Broad Institute, Cambridge, MA, United States. Clinical Research: Epidemiology and Observational Research