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50

NCCN Guidelines for Patients

®

Mycosis Fungoides, Version 1.2016

3

DCIS

Genetic counseling | Treatment

4

Treatment guide

Stage III treatment

Switch to third-line treatments if:

• Multiple courses of second-line treatment didn’t work, or

• The cancer is worse and is a higher cancer stage

Ž

Switch to second-line treatments if:

• Multiple courses of first-line treatment didn’t work, or

• The cancer is worse and is a higher cancer stage



Try another course of

second-line treatments

if:

• Treatment worked at

first but the cancer

came back as stage

III, or

• Only 1 or 2

treatments were tried

and didn’t work

Chart 4.4.2 Second-line treatments

Treatment options

• Combination treatment

Skin-directed + Systemic

◦◦ Phototherapy + retinoid

◦◦ Phototherapy + interferon

◦◦ Phototherapy +

photopheresis

◦◦ Total skin electron beam +

photopheresis

Systemic + Systemic

◦◦ Retinoid +

interferon

◦◦ Photopheresis + retinoid

◦◦ Photopheresis +

interferon

◦◦ Photopheresis + retinoid +

interferon

• Clinical trial

Chart 4.4.3 Third-line treatments

Treatment options

• Clinical trial

• Systemic treatment

◦◦ Brentuximab vedotin

◦◦ Gemcitabine

◦◦ Liposomal doxorubicin

◦◦ Low-dose pralatrexate

◦◦ Chlorambucil

◦◦ Pentostatin

◦◦ Etoposide

◦◦ Cyclophosphamide

◦◦ Temozolomide

◦◦ Low-dose methotrexate

◦◦ Bortezomib

• Alemtuzumab

• Nonmyeloblative allogeneic transplant