Xelijanz for mycosis fungoides with Jak 3 mutation.
Tofacitinib is used to treat certain types of arthritis (such as psoriatic arthritis, rheumatoid arthritis, polyarticular course juvenile idiopathic arthritis-pcJIA). It helps to decrease pain/tenderness/swelling in the joints. There is no standard treatment specifically approved for the rare T-cell lymphoma, Mycosis Fungoids. Valdivel writes that: “Our findings suggest that JAK3 may have a cytokine receptor-independent function in the nucleus of malignant T cells, and thus a novel non-canonical role in CTCL. There is scientific evidence were treatment with ruxolitinib (JAK1/2 inhibitor) inhibited CTCL cell proliferation and JAK/STAT activity in CTCL cell lines, while activated apoptosis and inhibiting DNA synthesis in CTCL cells.
This treatment meets the literature conditions of the policy.
Vadivel, C.K.; Gluud, M.;Torres-Rusillo, S.; Boding, L.;Willerslev-Olsen, A.; Buus, T.B.;Nielsen, T.K.; Persson, J.L.; Bonefeld,C.M.; Geisler, C.; et al. JAK3 Is
Expressed in the Nucleus of Malignant T Cells in Cutaneous T Cell Lymphoma (CTCL). Cancers 2021, 13, 280. https://doi.org/10.3390/
cancers13020280
Karagianni F at al, JAK/STAT Signaling Pathway and Inhibitors in Inflammatory and Neoplasmatic Skin Diseases. Annals of Hematologya dn ONcology. Volume 6 Issue 4 – 2019 ISSN : 2375-7965
Steven M.HorwitzMD1Tatyana A.Feldman et al, The Novel SYK/JAK Inhibitor Cerdulatinib Demonstrates Good Tolerability and Clinical Response in a Phase 2a Study in Relapsed/Refractory Peripheral T-Cell Lymphoma and Cutaneous T-Cell Lymphoma. Blood, Volume 132, Supplement 1, 29 November 2018, Page 1001