Publications by authors named "E Hodak"

233 Publications

Multicentric EORTC retrospective study shows efficacy of Brentuximab Vedotin in Μycosis Fungoides and Sezary Syndrome patients with variable CD30 positivity.

Br J Dermatol 2021 Jun 16. Epub 2021 Jun 16.

Department of Dermatology, Centre for Rare Diseases, University Hospital Birmingham, Birmingham, UK.

Background: Brentuximab Vedotin (BV) was approved as therapy for Mycosis Fungoides (MF) based on ALCANZA trial. Since then few real-life data are available.

Objective: The aim of this study was to evaluate efficacy and safety of BV in MF/Sezary Syndrome (SS) patients with variable CD30 positivity in real life cohort and explore potential predictors.

Methods: Data from 72 MF/SS patients across 9 EORTC (European Organization for Research and Treatment of Cancer) centers were included. The primary endpoint was to evaluate the proportion of patients with: overall response (ORR), ORR lasting over four months (ORR4), time to response (TTR), response duration (RD), progression free survival (PFS) and time to next treatment (TTNT). Secondary aims included safety evaluation and association of clinicopathological features with ORR, RD and TTNT.

Findings: Seventy-two patients were included; all had received at least one systemic treatment. ORR was achieved in 45/67; ORR4 in 28/67 with median TTR 8 weeks (IQR 5.5-14) and median RD 9 months (IQR 3.4-14). Median PFS was 7 months (IQR 2-12) and median TTNT 30 days (6-157.5). Patients' response, RD, PFS and TTNT were not associated with any clinicopathological characteristics. In MF group, patients with stage IIB/III versus IV achieved longer PFS and higher percentage of ORR4. There was statistically significant association between LCT and skin ORR (p=0.03). ORR4 was more frequently achieved in patients without lymph node involvement (p=0.04).

Conclusions: BV is an effective option for MF/SS patients including those with variable CD30 positivity, LCT, SS, longer disease duration and highly pretreated.
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http://dx.doi.org/10.1111/bjd.20588DOI Listing
June 2021

Is lymph node core-needle biopsy an alternative to excisional biopsy for the accurate staging of mycosis fungoides/Sézary syndrome and predicting the survival of patients?

Authors:
E Hodak

Br J Dermatol 2021 Jun 11. Epub 2021 Jun 11.

Division of Dermatology, Rabin Medical Center, Petah Tiqva and Sackler Faculty of Medicine, Tel Aviv University, Israel.

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http://dx.doi.org/10.1111/bjd.20496DOI Listing
June 2021

Post hoc Analysis of a Randomized, Controlled, Phase 2 Study to Assess Response Rates with Chlormethine/Mechlorethamine Gel in Patients with Stage IA-IIA Mycosis Fungoides.

Dermatology 2021 Jun 4:1-11. Epub 2021 Jun 4.

Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma. Patients can be treated using chlormethine gel, a skin-directed therapy developed and approved for MF. In the randomized, controlled 201 trial, chlormethine gel was found to be noninferior to equal-strength chlormethine ointment. However, there remains a need to gain more insight into outcome measures after treatment.

Objective: The aim of this study was to further investigate the potential of chlormethine gel treatment through a novel post hoc analysis of the 201 trial data (NCT00168064).

Methods: Patients were randomized to chlormethine gel or ointment; response assessments included Composite Assessment of Index Lesion Severity (CAILS) and total body surface area (BSA). In this post hoc analysis, additional subgroup response analyses were performed for stage IA/IB-IIA MF. Very good partial response (75 to <100% improvement) was included as an additional response category. Time to response and overall response trends were determined. Finally, multivariate time-to-event analyses were performed to determine whether associations were observed between treatment frequency, response, and adverse events.

Results: Response rates were significantly higher for patients with stage IA MF for CAILS (intent-to-treat [p = 0.0014] and efficacy-evaluable [EE; p = 0.0036] populations) and BSA (EE population [p = 0.0488]) treated with gel versus ointment. Time to first CAILS response and response trends were better for all-stage gel-treated patients overall. No association was seen between treatment frequency and response or occurrence of adverse events at the following visit. An association was observed between the occurrence of contact dermatitis and improved clinical response at the next visit (p = 0.0001).

Conclusion: This post hoc analysis shows that treatment with chlormethine gel may result in higher and faster response rates compared with chlormethine ointment, which confirms and expands results reported in the original analysis. The incidence of contact dermatitis may potentially be a prognostic indicator for clinical response; this needs to be confirmed in a larger population.
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http://dx.doi.org/10.1159/000516138DOI Listing
June 2021

Mycosis fungoides-derived exosomes promote cell motility, are enriched with miR-155 and miR-1246, and their plasma cell-free expression may serve as potential biomarkers for disease burden.

Br J Dermatol 2021 May 30. Epub 2021 May 30.

Laboratory for Molecular Dermatology, Felsenstein Medical Research Center, Petach Tikva, 4941492, Israel.

Background: Literature regarding exosomes as mediators in intercellular communication to promote progression in mycosis fungoides (MF) is lacking.

Objective: To characterize MF-derived exosomes and their involvement in the disease.

Methods: Exosomes were isolated by ultracentrifugation from cutaneous T-cell lymphoma (CTCL) cell lines, plasma of MF patients, and controls (healthy individuals), and confirmed by electron microscopy, NanoSight, and CD81 staining. Cell-line exosomes were profiled for miRNA array. Exosomal miRNA (exomiR) expression, uptake and plasma cell-free miRNA (cfmiRNA) were analyzed by RT-qPCR. Exosome uptake was monitored by fluorescent labeling and CD81 immunostaining. Migration was analyzed by transwell migration assay.

Results: MyLa and MJ-derived exosomes had a distinctive miRNA signature with abundant miR-155 and miR-1246. Both miRs were delivered into target cells, but only exomiR-155 was tested and demonstrated a migratory effect on target cells. Plasma levels of cfmiR-1246 were significantly highest in plaque/tumor MF, followed by patch MF and lowest in controls (plaque/tumor>patch>healthy), while cfmiR-155 was only upregulated in plaque/tumor MF vs controls. Specifically, exomiR-1246 (and not exomiR-155) was higher in plasma of plaque/tumor MF vs healthy. Plasma exosomes from MF but not controls increased cell migration.

Conclusion: Our findings showed that MF-derived exosomes promote cell motility and are enriched with miR-155, a well-known miR in MF and miR-1246, not previously reported in MF. Based on their plasma expression we suggest that they may serve as potential biomarkers for tumor burden.
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http://dx.doi.org/10.1111/bjd.20519DOI Listing
May 2021

Reply to: Comments on "Hidradenitis suppurativa and atopic dermatitis: A two-way association".

J Am Acad Dermatol 2021 May 24. Epub 2021 May 24.

Division of Dermatology, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

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http://dx.doi.org/10.1016/j.jaad.2021.05.019DOI Listing
May 2021
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