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Dr. Pei-Ling Chen, a member of the Pathology and Cutaneous Oncology Departments at Moffitt and a member of the Moffitt Cutaneous Lymphoma Multidisciplinary Clinic, recently joined the OncLive OnAir podcast to share insight and research findings regarding Cutaneous T-cell Lymphoma (CTCL).

CTCL is a rare cancer disease consisting of a group of incurable skin holding T-cells. In advanced stages of CTCL, the cancer can progress to areas such as lymph nodes, bladder and other organs. The number of incidences is 6.6 per 100,000 individuals, resulting in about 3,000 diagnoses a year. CTCL is more common in men, typically presenting in patients over 50 years of age.

Discoveries show advanced incidence rates in black/African American patients, including a higher risk of onset in younger adults, higher disease burden and greater mortality rate opposed to white patients. Early-stage indicators include scaly patches of different shapes and sizes commonly located on the sun-protected areas of the body. Symptoms may also include total body redness.

Due to the CTCL symptoms presenting as numerous benign inflammatory skin diseases, such as eczema and psoriasis, CTCL is one of the most challenging diseases to diagnose and may take multiple biopsies to confirm diagnosis. Advanced stages of CTCL can be highly fatal and often fails to result in progression-free survival responses after treatment of systemic therapies.

Dr. Chen's primary objectives were to understand the genomic landscape and potential therapeutic vulnerabilities of CTCL and large cell transformation. Secondly, how is advanced stage disease in the skin compartment different from the advanced stage disease in the blood compartment of the genomic level. The study included collecting skin biopsies and fresh tissue specimens from cohorts of 56 patients with transformed CTCL.

Findings showed that transformed CTCL has a high tumor mutation burden, and that UV signature is prognostic in favorable survival from time of large cell transformation. Moreover, discoveries showed when stratifying the whole essence sequence data from black/African American versus white patients, black/African American patients showed refused UV signature and unique signature cluster with CNA mismatch repair and some unknown mutation signatures. These findings presented the first genomic study that provides a glimpse of potential genomic outcomes of racial disparities in CTCL. Additionally, Dr. Chen shared her prospected findings from the Phase 3 FLASH trial and the need for additional research funding in CTCL.

Listen to the entire podcast.

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