The use of systemic and skin-directed therapies increased among patients with Sézary syndrome between 2018 and 2020, according to findings presented at the American Society of Clinical Oncology Annual Meeting.

“Sézary syndrome (SS) is an aggressive type of cutaneous T-cell lymphomas (CTCL),” Yang Zhao and colleagues wrote. “Due to its low prevalence, there are limited data on real-world treatment patterns of currently available SS therapies. Furthermore, recent approvals of new agents for patients with CTCL as well as COVID-19 likely impacted real-world treatment patterns.”

Zhao and colleagues aimed to determine real-world treatment patterns and the effect of the COVID-19 pandemic on patients with SS treated in the United States between 2018 and 2020.

Patients with public or private insurance were classified into three groups, based on one or more diagnoses of SS in 2018, 2019, and 2020. The researchers examined patient characteristics and treatment patterns according to all therapies recommended by the National Comprehensive Cancer Network, including systemic therapy, skin-directed therapy (SDT), and bone marrow transplant. The impact of COVID-19 was evaluated using a quarterly analysis.

Changing Treatment Patterns & The Impact of COVID-19

The study included 869 patients diagnosed in 2018, 882 diagnosed in 2019, and 853 diagnosed in 2020. The mean age of patients was 66.3 in 2018 (54.4% male), 66.9 in 2019 (54.8% male), and 67.3 in 2020 (55.6% men).

“Overall, systemic therapy increased from 2018 to 2020 (41.8% to 46.5%),” Zhao and colleagues wrote.

During this period, the study team observed heightened use of parenteral therapy (20.7% vs 28.7%) and reduced use of extracorporeal photopheresis (ECP; 17.0% vs 13.5%). Rates of SDT also increased from 2018 to 2020 (48.9% vs 52.9%), with greater use of topical therapy (42.3% vs 48.3%) but lower use of phototherapy (6.3 vs 4.1%).

The quarterly analysis demonstrated a reduction in the use of ECP from the first quarter to the fourth quarter of the year within each year, with a “notable drop” in the second quarter of 2020. Regarding parenteral systemics, Zhao and colleagues saw an increasing trend in 2019 and 2020, though use in the fourth quarter of 2020 was lower than that of the third quarter of 2020. The study team also reported another “notable drop” in the use of oral systemic therapies in the second quarter of 2020, though they also saw an increasing trend in the third and fourth quarters of 2020.

“This claims analysis indicated increased use in systemic and SDT among [patients with SS] in 2018-2020,” Zhao and colleagues wrote. “The quarterly analysis indicated that the drop in ECP and oral systemic usage in [quarter 2 of 2020] coincided with the onset of the pandemic, but there was a stable use of parenteral systemic during 2020.”