Phototherapy combined with systemic agents for mycosis fungoides

Cover Page

Cite item

Full Text

Abstract

The choice of tactics for managing a patient with mycosis fungoides is determined by the stage of the disease. In the early stages of mycosis fungoides, a treatment approach using external therapy and various ultraviolet irradiation spectra (UVB-311 nm and PUVA therapy) is preferable. With insufficient efficiency and / or short remissions in some patients, it is possible to use combined methods in the early stages: PUVA therapy or UVB-311 nm therapy. in combination with systemic therapy, including interferon (IFN) α2b preparations, methotrexate and retinoids. The results of original studies demonstrate an increase in the overall response rate when combining PUVA therapy with IFN-α or retinoids in patients with stages IB-IIB. The effectiveness of combined treatment regimens using UVB-311 nm remains insufficiently studied.

About the authors

Anastasiia A. Vorontsova

State Research Center of Dermatovenereology and Cosmetology

Email: nastasia08@bk.ru
ORCID iD: 0000-0002-3129-0050
SPIN-code: 8334-2890

Junior Research Associate

Russian Federation, Korolenko str., 3, bldg 6, 107076, Moscow

Arfenya E. Karamova

State Research Center of Dermatovenereology and Cosmetology

Author for correspondence.
Email: karamova@cnikvi.ru
ORCID iD: 0000-0003-3805-8489
SPIN-code: 3604-6491

MD, Cand. Sci. (Med.) Assistant Professor

Russian Federation, Korolenko str., 3, bldg 6, 107076, Moscow

References

  1. Российские клинические рекомендации по диагностике и лечению лимфопролиферативных заболеваний. Под ред. И.В. Поддубной, В.Г. Савченко. М.: Буки Веди, 2016. 324 c. [Rossijskie klinicheskie rekomendacii po diagnostike i lecheniju limfoproliferativnyh zabolevanij (Russian clinical guidelines for the diagnosis and treatment of lymphoproliferative diseases). Ed. by IV Poddubnoy, VG Savchenko. Moscow: Buki Vedi 2016. 344 p. (In Russ.)]
  2. Olsen E, Vonderheid E, Pimpinelli N, Willemze R, Kim Y, Knobler R, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: A proposal of the International Sosiety for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC). Blood. 2007;110(6):1713–1722. doi: 10.1182/blood-2007-03-055749
  3. Agar NS, Wedgeworth E, Crichton S, Mitcnell TJ, Cox M, Ferreira S, et al. Survival outcomes and prognostic factors in mycosis fungoides/Sézary syndrome: validation of the revised International Society for Cutaneous Lymphomas/ European Organisation for Research and Treatment of Cancer staging proposal. J Clin Oncol. 2010;28(31):4730–4739. doi: 10.1200/JCO.2009.27.7665
  4. Клинические рекомендации по диагностике и лечению грибовидного микоза. Рубрикатор клинических рекомендаций. [Klinicheskie rekomendacii po diagnostike i lecheniju gribovidnogo mikoza. Rubrikator klinicheskih rekomendacij (Clinical recommendations for the diagnosis and treatment of mycosis fungoides. Rubricator of clinical recommendations). (In Russ.)] https://cr.minzdrav.gov.ru/recomend/223_1 (20 November 2022)
  5. Trautinger F, Knobler R, Willemze R, Peris K, Stadler R, Laroche L, et al. EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome. Eur J Cancer. 2006;42(8):1014–1030. doi: 10.1016/j.ejca.2006.01.025
  6. Phan K, Ramachandran V, Fassihi H, Sebaratnam DF. Comparison of Narrowband UV-B With Psoralen–UV-A Phototherapy for Patients With Early-Stage Mycosis Fungoides: A Systematic Review and Meta-analysis. JAMA Dermatol. 2019;155(3):335–341. doi: 10.1001/jamadermatol.2018.5204
  7. Ross C, Tingsgaard P, Jørgensen H, Vejlsgaard GL. Interferon treatment of cutaneous T-cell lymphoma. Eur J Haematol. 1993;51(2):63–72. doi: 10.1111/j.1600-0609.1993.tb01595.x
  8. Zackheim HS, Kashani-Sabet M, McMillan A. Low-dose methotrexate to treat mycosis fungoides: a retrospective study in 69 patients. J Am Acad Dermatol. 2003;49(5):873–878. doi: 10.1016/s0190-9622(03)01591-3
  9. Suchin KR, Cassin M, Gottleib SL, Sood S, Cucchiara AJ, Vonderheid EC, et al. Increased interleukin 5 production in eosinophilic Sézary syndrome: regulation by interferon alfa and interleukin 12. J Am Acad Dermatol. 2001;44(1):28–32. doi: 10.1067/mjd.2001.109853
  10. Spaccarelli N, Rook AH. The Use of Interferons in the Treatment of Cutaneous T-Cell Lymphoma. Dermatol Clin. 2015;33(4):731–745. doi: 10.1016/j.det.2015.05.008
  11. Roenigk HH Jr, Kuzel TM, Skoutelis AP, Springer E, Yu G, Caro W, et al. Photochemotherapy alone or combined with interferon alpha-2a in the treatment of cutaneous T-cell lymphoma. J Invest Dermatol. 1990;95(6 Suppl.):198S–205S. doi: 10.1111/1523-1747
  12. Kuzel TM, Gilyon K, Springer E, Variakojis D, Kaul K, Bunn PA, et al. Interferon alfa-2a Combined With Phototherapy in the Treatment of Cutaneous T-Cell Lymphoma. J Natl Cancer Inst. 1990;82(3):203–207. doi: 10.1093/jnci/82.3.203
  13. Stadler R, Otte HG, Luger T, Henz BM, Kuhl P, Zwingers T, et al. Prospective randomized multicenter clinical trial on the use of interferon-2a plus acitretin versus interferon-2a plus PUVA in patients with cutaneous T-cell lymphoma stages I and II. Blood. 1998;92(10):3578–3581.
  14. Nikolaou V, Siakantaris MP, Vassilakopoulos TP, Papadavid E, Stratigos A, Economidi A, et al. PUVA plus interferon aa-2b in the treatment of advanced or refractory to PUVA early stage mycosis fungoides: a case series. J Eur Acad Dermatol Venereol. 2011;25(3):354–357. doi: 10.1111/j.1468-3083.2010.03732.x
  15. Wozniak MB, Tracey L, Ortiz-Romero PL, Montes S, Alvarez M, Fraga J, et al. Psoralen plus ultraviolet A +/- interferon-alpha treatment resistance in mycosis fungoides: the role of tumour microenvironment, nuclear transcription factor-kappaB and T-cell receptor pathways. Br J Dermatol. 2009;160(1):92–102. doi: 10.1111/j.1365-2133.2008.08886.x
  16. Олисова О.Ю., Смирнов К.В., Грекова Е.В. Комбинация ПУВА-терапии с интерфероном  у больных грибовидным микозом. Российский журнал кожных и венерических болезней. 2017;20(3):132–139 [Olisova OY, Smirnov KV, Grekova EV. PUVA and interferon combined therapy in patients with mycosis fungoides. Rossijskij zhurnal kozhnyh i venericheskih boleznej. 2017;20(3):132–139. (In Russ.)] doi: 10.18821/1560-9588-2017-20-3-132-139
  17. Olsen EA, Bunn PA. Interferon in the Treatment of Cutaneous T-cell Lymphoma. Hematol Oncol Clin North Am. 1995;9(5):1089–1107.
  18. Gisslinger H, Gilly B, Woloszczuk W, Havelec L, Linkesch W, Weissel M. Thyroid autoimmunity and hypothyroidism during long-term treatment with recombinant interferon-alpha. Clin Exp Immunol. 1992;90(3):363–367. doi: 10.1111/j.1365-2249.1992.tb05852.x
  19. Watanabe U, Hashimoto E, Hisamitsu T, Obata H, Hayashi N. The risk factor for development of thyroid disease during interferon-alpha therapy for chronic hepatitis C. Am J Gastroenterol 1994:89(3):399–403.
  20. Kuriyama K, Hori T, Mori T, Nakashima T. Actions of interferon alpha and interleukin-1 beta on the glucose-responsive neurons in the ventromedial hypothalamus. Brain Res Bull. 1990;24(6):803–810. doi: 10.1016/0361-9230(90)90143-n
  21. Alexander M. Treatment of mycosis fungoides with isotretinoin. Lancet. 1983:2(8347):463. doi: 10.1016/s0140-6736(83)90435-x
  22. Claudy AL, Rouchouse B, Boucheron S, Le Petit JC. Treatment of cutaneous lymphoma with etretinate. Br J Dermatol. 1983;109(1):49–56. doi: 10.1111/j.1365-2133.1983.tb03991.x
  23. Degos L, Parkinson DR (eds). Retinoids in Oncology. Berlin, Heidelberg: Springer; 1995. 115 p.
  24. Rook AH, Kubin M, Fox FE, Niu Z, Cassin M, Vowels BR, et al. The potential therapeutic role of interleukin-12 in cutaneous T-cell lymphoma. Ann N Y Acad Sci. 1996;795:310–318. doi: 10.1111/j.1749-6632.1996.tb52680.x
  25. Dummer R, Kohl O, Gillessen J, Kägi M, Burget G. Peripheral blood mononuclear cells in patients with nonleukemic cutaneous T-cell lymphoma. Reduced proliferation and preferential secretion of a T helper-2-like cytokine pattern on stimulation. Arch Dermatol. 1993;129(4):433–436.
  26. Zhang C, Hazarika P, Ni X, Weidner DA, Duvic M. Induction of apoptosis by bexarotene in cutaneous T-cell lymphoma cells: relevance to mechanism of therapeutic action. Clin Cancer Res. 2002;8(5):1234–1240.
  27. Richardson SK, Newton SB, Bach TL, Budgin JB, Benoit BM, Lin JH, et al. Bexarotene blunts malignant T-cell chemotaxis in Sezary syndrome: reduction of chemokine receptor 4-positive lymphocytes and decreased chemotaxis to thymus and activation-regulated chemokine. Am J Hematol. 2007;82(9):792–797. doi: 10.1002/ajh.20952
  28. Zhang C, Duvic M. Treatment of cutaneous T-cell lymphoma with retinoids. Dermatol Ther. 2006;19(5):264–271. doi: 10.1111/j.1529-8019.2006.00083.x
  29. Sokołowska-Wojdyło M, Lugowska-Umer H, Maciejewska-Radomska A. Oral retinoids and rexinoids in cutaneous T-cell lymphomas. Postepy Dermatol Alergol. 2013;30(1):19–29. doi: 10.5114/pdia.2013.33375
  30. Henney JE. From the Food and Drug Administration. JAMA. 2000:283(9):1131.
  31. Thomsen K, Hammar H, Molin L, Volden G. Retinoids plus PUVA (RePUVA) and PUVA in mycosis fungoides, plaque stage. A report from the Scandinavian Mycosis Fungoides Group. Acta Derm Venereol. 1989;69(5):536–538.
  32. Serri F, De Simone C, Venier A, Rusciani L, Marchetti F. Combination of retinoids and PUVA (re-PUVA) in the treatment of cutaneous T cell lymphomas. Curr Probl Dermatol. 1990;19:252–257. doi: 10.1159/000418097
  33. Nikolaou V, Patsatsi A, Sidiropoulou P, Chlouverakis G, Kavvalou E, Koletsa T, et al. Monotherapy and combination therapy with acitretin for mycosis fungoides: results of a retrospective, multicentre study. J Eur Acad Dermatol Venereol. 2020;34(11):2534–2540. doi: 10.1111/jdv.16567
  34. Warrell RP Jr, Coonley CJ, Kempin SJ, Myskowski P, Safai B, Itri LM. Isotretinoin in cutaneous T-cell lymphoma. Lancet. 1983;2(8350):629. doi: 10.1016/s0140-6736(83)90717-1
  35. Molin L, Thomsen K, Volden G, Aronsson A, Hammar H, Hellbe L, et al. Oral retinoids in mycosis fungoides and Sézary syndrome: a comparison of isotretinoin and etretinate. A study from the Scandinavian Mycosis Fungoides Group. Acta Dermatol Venereol. 1987;67(3):232–236.
  36. Whittaker S, Ortiz P, Dummer R, Ranki A, Hasan B, Meulemans B, et al. Efficacy and safety of bexarotene combined with psoralen-ultraviolet A (PUVA) compared with PUVA treatment alone in stage IB-IIA mycosis fungoides: final results from the EORTC Cutaneous Lymphoma Task Force phase III randomized clinical trial (NCT00056056). Br J Dermatol. 2012;167(3):678–687. doi: 10.1111/j.1365-2133.2012.11156.x
  37. Morita A, Tateishi C, Ikumi K, Hayashi D, Nakada A, Nishihara H, et al. Comparison of the Efficacy and Safety of Bexarotene and Photo(Chemo)Therapy Combination Therapy and Bexarotene Monotherapy for Cutaneous T-Cell Lymphoma. Dermatol Ther (Heidelb). 2022;12(3):615–629. doi: 10.1007/s13555-021-00655-0
  38. Duvic M, Martin AG, Kim Y, Olsen E, Wood GS, Crowley CA, et al. Phase 2 and 3 clinical trial of oral bexarotene (Targretin capsules) for the treatment of refractory or persistent early-stage cutaneous T-cell lymphoma. Arch Dermatol. 2000;137(5):581–593.
  39. Duvic M, Hymes K, Heald P, Breneman D, Martin AG, Myskowski P, et al. Bexarotene is effective and safe for treatment of refractory advanced-stage cutaneous T-cell lymphoma: multinational phase II–III trial results. J Clin Oncol. 2001;19(9):2456–2471. doi: 10.1200/JCO.2001.19.9.2456
  40. Talpur R, Ward S, Apisarnthanarax N, Breuer-Mcham J, Duvic M. Optimizing bexarotene therapy for cutaneous T-cell lymphoma. J Am Acad Dermatol. 2002;47(5):672–684. doi: 10.1067/mjd.2002.124607
  41. Dogra S, Mahajan R. Phototherapy for mycosis fungoides. Indian J Dermatol Venereol Leprol. 2015;81(2):124–135. doi: 10.4103/0378-6323.152169
  42. Olsen EA, Hodak E, Anderson T, Carter JB, Henderson M, Cooper K, et al. Guidelines for phototherapy of mycosis fungoides and Sézary syndrome: A consensus statement of the United States Cutaneous Lymphoma Consortium. J Am Acad Dermatol. 2016;74(1):27–58. doi: 10.1016/j.jaad.2015.09.033
  43. MacKie RM, Fitzsimons CP. Risk of carcinogenicity in patients with psoriasis treated with methotrexate or PUVA singly or in combination. J Am Acad Dermatol. 1983;9(3):467–469. doi: 10.1016/s0190-9622(83)80215-1
  44. Mahajan R, Kaur I, Kanwar AJ. Methotrexate/narrowband UVB phototherapy combination vs. narrowband UVB phototherapy in the treatment of chronic plaque-type psoriasis--a randomized single-blinded placebo-controlled study. J Eur Acad Dermatol Venereol. 2010;24(5):595–600. doi: 10.1111/j.1468-3083.2009.03486.x
  45. Morison WL, Momtaz K, Parrish JA, Fitzpatrick TB. Combined methotrexate-PUVA therapy in the treatment of psoriasis. J Am Acad Dermatol. 1982;6(1):46–51. doi: 10.1016/s0190-9622(82)70005-2
  46. Shehzad T, Dar NR, Zakria M. Efficacy of concomitant use of PUVA and methotrexate in disease clearance time in plaque type psoriasis. J Pak Med Assoc. 2004;54(9):453–455.
  47. Woo YR, Lee HM, Lee JS, Koo DW. Long-term follow-up of refractory mycosis fungoides which achieved remission with the addision of isotretinoin to methotrexate and psoralen plus ultraviolat a therapy. Ann Dermatol. 2013;25(2):259–260. doi: 10.5021/ad.2013.25.2.259
  48. Booken N, Weiss C, Utikal J, Felcht M, Goerdt S, Klemke CD. Combination therapy with extracorporeal photopheresis, interferon-alpha, PUVA and topical corticosteroids in the management of Sézary syndrome. J Dtsch Dermatol Ges. 2010;8(6):428–438. doi: 10.1111/j.1610-0387.2010.07319.x
  49. Rupoli S, Goteri G, Pulini S, Filosa A, Tassetti A, Offidani M, et al. Long-term experience with low-dose interferon-alpha and PUVA in the management of early mycosis fungoides. Eur J Haematol. 2005;75(2):136–145. doi: 10.1111/j.1600-0609.2005.00497.x
  50. Chiarion-Sileni V, Bononi A, Fornasa CV, Soraru M, Alaibac M, Ferrazzi E, et al. Phase II trial of interferon-alpha-2a plus psolaren with ultraviolet light A in patients with cutaneous T-cell lymphoma. Cancer. 2002;95(3):569–575. doi: 10.1002/cncr.10706
  51. Stadler R, Otte HG. Combination therapy of cutaneous T cell lymphoma with interferon alpha-2a and photochemotherapy. Recent Results Cancer Res. 1995;139:391–401. doi: 10.1007/978-3-642-78771-3_30
  52. Hüsken AC, Tsianakas A, Hensen P, Nashan D, Loquai C, Beissert S, et al. Comparison of pegylated interferon -2b plus psoralen PUVA versus standard interferon -2a plus PUVA in patients with cutaneous T-cell lymphoma. J Eur Acad Dermatol Venereol. 2012;26(1):71–78. doi: 10.1111/j.1468-3083.2011.04011.x
  53. Mostow EN, Neckel SL, Oberhelman L, Anderson TF, Cooper KD. Complete remissions in psoralen and UV-A (PUVA)-refractory mycosis fungoides-type cutaneous T-cell lymphoma with combined interferon alfa and PUVA. Arch Dermatol. 1993;129(6):747–752.
  54. Singh F, Lebwohl MG. Cutaneous T-cell lymphoma treatment using bexarotene and PUVA: a case series. J Am Acad Dermatol. 2004;51(4):570–573. doi: 10.1016/j.jaad.2003.05.010
  55. Papadavid E, Antoniou C, Nikolaou V, Siakantaris M, Vassilakopoulos TP, Stratigos A, et al. Safety and efficacy of low-dose bexarotene and PUVA in the treatment of patients with mycosis fungoides. Am J Clin Dermatol. 2008;9(3):169–173. doi: 10.2165/00128071-200809030-00005
  56. Delfino C, Grandi V, Pileri A, Rupoli S, Quaglino P, Alterini R, et al. Combination treatment in CTCL: the current role of bexarotene. G Ital Dermatol Venereol. 2012;147(6):573–580.
  57. Humme D, Nast A, Erdmann R, Vandersee S, Beyer M. Systematic review of combination therapies for mycosis fungoides. Cancer Treat Rev. 2014;40(8):927–933. doi: 10.1016/j.ctrv.2014.06.005
  58. D'Acunto C, Gurioli C, Neri I. Plaque stage mycosis fungoides treated with bexarotene at low dosage and UVB-NB. J Dermatolog Treat. 2010;21(1):45–48. doi: 10.3109/09546630903103980
  59. Lokitz ML, Wong HK. Bexarotene and narrowband ultraviolet B phototherapy combination treatment for mycosis fungoides. Photodermatol Photoimmunol Photomed. 2007;23(6):255–257. doi: 10.1111/j.1600-0781.2007.00315.x
  60. Hino R, Shimauchi T, Tokura Y. Treatment with IFN-gamma increases serum levels of Th1 chemokines and decreases those of Th2 chemokines in patients with mycosis fungoides. J Dermatol Sci. 2005;38(3):189–195. doi: 10.1016/j.jdermsci.2005.01.005
  61. Shimauchi T, Sugita K, Nishio D, Isoda H, Abe S, Yamada Y, et al. Alterations of serum Th1 and Th2 chemokines by combination therapy of interferon-gamma and narrowband UVB in patients with mycosis fungoides. J Dermatol Sci. 2008;50(3):217–225. doi: 10.1016/j.jdermsci.2007.12.004
  62. Fujii M, Uehara J, Honma M, Ito Y, Takahashi H, Ishida-Yamamoto A, et al. Primary cutaneous -T-cell lymphoma treated with low-dose methotrexate and narrowband ultraviolet B irradiation: report of a case with testicular involvement. J Dermatol. 2011;38(4):368–372. doi: 10.1111/j.1346-8138.2010.00998.x
  63. Перечень редких (орфанных) заболеваний [Perechen' redkih (orfannyh) zabolevanij (List of rare (orphan) diseases). (In Russ.)] https://minzdrav.gov.ru/documents/8048 (20 November 2022)
  64. Valipour A, Jäger M, Wu P, Schmitt J, Bunch C, Weberschock T. Interventions for mycosis fungoides. Cochrane Database Syst Rev. 2020;7(7):CD008946. doi: 10.1002/14651858.CD008946.pub3
  65. Van Weelden H, Baart de la Faille H, Young E, Leun JC van der. Comparison of narrow-band UV-B phototherapy and PUVA photochemotherapy in the treatment of psoriasis. Acta Derm Venereol. 1990;70(3):212–215.
  66. Young A. Carcinogenicity of UVB phototherapy assessed. Lancet. 1995;345:1431–1432. doi: 10.1016/S0140-6736(95)92617-8
  67. Slaper H, Schothorst AA, Leun JC van der. Risk evaluation of UVB therapy for psoriasis: comparison of calculated risk for UVB therapy and observed risk in PUVA-treated patients. Photodermatol. 1986;3(5):271–283.
  68. Nikolaou V, Marinos L, Moustou E, Papadavid E, Economidi A, Christofidou E, et al. Psoriasis in patients with mycosis fungoides: a clinicopathological study of 25 patients. J Eur Acad Dermatol Venereol. 2017;31(11):1848–1852. doi: 10.1111/jdv.14365
  69. Yoo J, Shah F, Velangi S, Stewart G, Scarisbrick JS. Secukinumab for treatment of psoriasis: does secukinumab precipitate or promote the presentation of cutaneous T-cell lymphoma? Clin Exp Dermatol. 2019;44(4):414–417. doi: 10.1111/ ced.13777
  70. Diakomopoulos A, Dalamaga M, Papadavid E. Understanding the enigmatic association between mycosis fungoides and psoriasis: Report of two cases and review of the literature. Metabol Open. 2021;12:100148. doi: 10.1016/j.metop.2021.100148
  71. Mahajan R, Kaur I, Kanwar AJ. Methotrexate/narrowband UVB phototherapy combination vs. narrowband UVB phototherapy in the treatment of chronic plaque-type psoriasis--a randomized single-blinded placebo-controlled study. J Eur Acad Dermatol Venereol. 2010;24(5):595–600. doi: 10.1111/j.1468-3083.2009.03486.x
  72. Soonthornchai W, Tangtanatakul P, Meephansan J, Ruchusatsawat K, Reantragoon R, Hirankarn N, et al. Down-regulation of miR-155 after treatment with narrow-band UVB and methotrexate associates with apoptosis of keratinocytes in psoriasis. Asian Pac J Allergy Immunol. 2021;39(3):206–213. doi: 10.12932/AP-031218-0451
  73. Moyal L, Barzilai A, Gorovitz B, Hirshberg A, Amariglio N, Jacob-Hirsch J, et al. miR-155 is involved in tumor progression of mycosis fungoides. Exp Dermatol. 2013;22(6):431–433. doi: 10.1111/exd.12161

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2023 Vorontsova A.A., Karamova A.E.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Согласие на обработку персональных данных с помощью сервиса «Яндекс.Метрика»

1. Я (далее – «Пользователь» или «Субъект персональных данных»), осуществляя использование сайта https://journals.rcsi.science/ (далее – «Сайт»), подтверждая свою полную дееспособность даю согласие на обработку персональных данных с использованием средств автоматизации Оператору - федеральному государственному бюджетному учреждению «Российский центр научной информации» (РЦНИ), далее – «Оператор», расположенному по адресу: 119991, г. Москва, Ленинский просп., д.32А, со следующими условиями.

2. Категории обрабатываемых данных: файлы «cookies» (куки-файлы). Файлы «cookie» – это небольшой текстовый файл, который веб-сервер может хранить в браузере Пользователя. Данные файлы веб-сервер загружает на устройство Пользователя при посещении им Сайта. При каждом следующем посещении Пользователем Сайта «cookie» файлы отправляются на Сайт Оператора. Данные файлы позволяют Сайту распознавать устройство Пользователя. Содержимое такого файла может как относиться, так и не относиться к персональным данным, в зависимости от того, содержит ли такой файл персональные данные или содержит обезличенные технические данные.

3. Цель обработки персональных данных: анализ пользовательской активности с помощью сервиса «Яндекс.Метрика».

4. Категории субъектов персональных данных: все Пользователи Сайта, которые дали согласие на обработку файлов «cookie».

5. Способы обработки: сбор, запись, систематизация, накопление, хранение, уточнение (обновление, изменение), извлечение, использование, передача (доступ, предоставление), блокирование, удаление, уничтожение персональных данных.

6. Срок обработки и хранения: до получения от Субъекта персональных данных требования о прекращении обработки/отзыва согласия.

7. Способ отзыва: заявление об отзыве в письменном виде путём его направления на адрес электронной почты Оператора: info@rcsi.science или путем письменного обращения по юридическому адресу: 119991, г. Москва, Ленинский просп., д.32А

8. Субъект персональных данных вправе запретить своему оборудованию прием этих данных или ограничить прием этих данных. При отказе от получения таких данных или при ограничении приема данных некоторые функции Сайта могут работать некорректно. Субъект персональных данных обязуется сам настроить свое оборудование таким способом, чтобы оно обеспечивало адекватный его желаниям режим работы и уровень защиты данных файлов «cookie», Оператор не предоставляет технологических и правовых консультаций на темы подобного характера.

9. Порядок уничтожения персональных данных при достижении цели их обработки или при наступлении иных законных оснований определяется Оператором в соответствии с законодательством Российской Федерации.

10. Я согласен/согласна квалифицировать в качестве своей простой электронной подписи под настоящим Согласием и под Политикой обработки персональных данных выполнение мною следующего действия на сайте: https://journals.rcsi.science/ нажатие мною на интерфейсе с текстом: «Сайт использует сервис «Яндекс.Метрика» (который использует файлы «cookie») на элемент с текстом «Принять и продолжить».