Pegylated interferon alfa-2a (Pegasys) was shown to have a tolerable and manageable safety profile in patients with cutaneous T-cell lymphoma (CTCL), according to real-world data presented at the 6th World Congress on Cutaneous Lymphomas.1
Of 94 evaluable patients, 73% experienced at least 1 adverse effect (AE). The most common AEs that patients experienced were flu-like symptoms and cytopenias. In addition, approximately 10% of patients experienced mood changes. The investigators observed other AEs less frequently, and each occurred in 3% or fewer patients.
Over 90% of the reported AEs were classified as mild or moderate. Grade 1 (65%), grade 2 (27%), and grade 3 (8%) AEs were observed. Only 1 patient had a grade 4 AE, which was severe neutropenia. All AEs were manageable with supportive care, dose reduction, or treatment discontinuation.
Of the total population, 68% of patients discontinued study treatment. Most patients who discontinued treatment did so because of non-AE factors; only 35% of treatment cessations were due to AEs. Other reasons for treatment discontinuation were lack of response/disease progression (17%), death unrelated to treatment (15%), cost (13%), patient choice (8%), other reason (6%), and complete response (5%).
Overall, patients had a median duration of treatment of 19 months (range, 3-30).
“All in all, these findings hopefully support greater clinician confidence in pegylated interferon alfa as a flexible, tolerable treatment option for CTCL,” Christina Cruz, a medical student at the University of Pennsylvania in Philadelphia, said in a presentation of the data.
What is the rationale for using pegylated interferon alfa-2a as a treatment for patients with CTCL?
Interferon alfa has a history of use in CTCL, although its AE profile and the evolving CTCL treatment paradigm have led to variations in its implementation. Interferon alfa-2b was discontinued in 2021, but pegylated interferon alfa-2a has been used as an off-label alternative.2 However, there is a dearth of real-world data with pegylated interferon alfa-2a in CTCL.1
Real-World Use of Pegylated Interferon Alfa-2a in CTCL: Safety Highlights
- Real-world data indicate that pegylated interferon alfa-2a has a manageable safety profile in patients with CTCL, with over 90% of AEs being mild or moderate in severity.
- Patients maintained a median treatment duration of 19 months, and notably, only 35% of those who discontinued the therapy did so due to AEs.
- The study supports the use of pegylated interferon alfa-2a as a flexible treatment option that is frequently used in combination with other topical and systemic therapies across various stages of the disease.
What was the design of this real-world study of pegylated interferon alfa-2a in CTCL?
This retrospective chart review included patients with CTCL treated at the University of Pennsylvania who received pegylated interferon alfa-2a for at least 3 months between October 2020 and October 2025. Patients were treated at weekly doses ranging from 18 µg to 180 µg. Notably, pegylated interferon alfa-2a is approved for the management of hepatitis B and C at 180 µg weekly. The median dose was 72 mcg (interquartile range, 40-90).
What were the baseline characteristics of the patients with CTCL evaluated in this real-world study of pegylated interferon alfa-2a?
Patients had a median age of 69 years (range, 23-92), and most were male (70.2%) and White (69.1%). CTCL stages included IA to IIA (53%), IB (13%), IIIA to IIIB (13%), IVA (17%), IVB (1%), and clinical remission (3%). In total, 76% of patients received combination therapy consisting of any topical therapy (84.0%) and/or any systemic therapy (71.3%).
What concomitant therapies were used with pegylated interferon alfa-2a in the real-world CTCL setting?
Patients frequently received pegylated interferon alfa-2a in combination with other systemic therapies. Concomitant therapies include topical steroids (80.9%), oral bexarotene (41.5%), extracorporeal photopheresis (26.6%), narrowband ultraviolet B (18.1%), carmustine (17.0%), mogamulizumab-kpkc (Poteligeo; 16.0%), total skin electron beam therapy (9.6%), mechlorethamine gel (Valchlor; 7.4%), localized radiotherapy (7.4%), interferon gamma-1b (4.3%), imiquimod (Aldara; 4.3%), psoralen and ultraviolet A (3.2%), and other therapy (6.4%).
References
- Cruz C, Cesar L, Lin S, et al. Interferon alfa lives on: real-world use and safety of pegylated interferon alfa-2a in cutaneous T-cell lymphoma. Presented at: 6th World Congress on Cutaneous Lymphomas; June 25-27, 2026; Montreal, Quebec, Canada. Abstract 9A.03.
- Gosmann J, Stadler R, Quint KD, et al. Use of pegylated interferon alpha-2a in cutaneous T-cell lymphoma: a retrospective case collection. Acta Derm Venereol. 2023;103:adv10306. doi:10.2340/actadv.v103.10306
