Update on treatment of cutaneous T-cell lymphoma

Current Opinion in Oncology

Volumn 21, Issue 2, 2009, Pages 131-137

  Gardner, Jennifer M ^a   Evans, Katherine G ^a   Musiek, Amy ^a   Rook, Alain H ^a   Kim, Ellen J ^a  

^a HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

Cutaneous T cell lymphoma; Mycosis fungoides; S zary syndrome; Treatment

Indexed keywords

ALEMTUZUMAB; ALPHA INTERFERON; AMINOLEVULINIC ACID; BCX 17; BEXAROTENE; BORTEZOMIB; CARMUSTINE; CHLORMETHINE; CORTICOSTEROID; CYCLOPHOSPHAMIDE; DENILEUKIN DIFTITOX; DOXORUBICIN; ETOPOSIDE; FORODESINE; GEMCITABINE; IMIQUIMOD; INTERFERON; INTERLEUKIN 12; INTERLEUKIN 15; INTERLEUKIN 2; LENALIDOMIDE; METHOTREXATE; PANOBINOSTAT; PENTOSTATIN; RETINOID; ROMIDEPSIN; TEMOZOLOMIDE; TG 1042; TOLL LIKE RECEPTOR AGONIST; UNCLASSIFIED DRUG; UNINDEXED DRUG; VORINOSTAT; ZANOLIMUMAB;

ACUTE INFUSION REACTION; ADVERSE DRUG REACTION; ANOREXIA; CLINICAL TRIAL; CUTANEOUS T CELL LYMPHOMA; DIARRHEA; DRUG EFFECT; DRUG EFFICACY; DRUG MEGADOSE; DRUG RESPONSE; ECZEMA; FATIGUE; FLU LIKE SYNDROME; HUMAN; HYPOALBUMINEMIA; HYPOTHYROIDISM; INFECTION; LIVER FUNCTION TEST; LOW DRUG DOSE; MULTIMODALITY CANCER THERAPY; MULTIPLE CYCLE TREATMENT; MYCOSIS FUNGOIDES; NAUSEA; OPPORTUNISTIC INFECTION; PATHOPHYSIOLOGY; PHOTOTHERAPY; PRIORITY JOURNAL; PUVA; REVIEW; SEZARY SYNDROME; SIDE EFFECT; SYNDROME; T CELL DEPLETION; THROMBOCYTOPENIA; THYROID DISEASE; THYROIDOSIS; VASCULAR LEAK SYNDROME;

ALKYLATING AGENTS; ANTICARCINOGENIC AGENTS; COMBINED MODALITY THERAPY; HUMANS; IMMUNOLOGIC FACTORS; LYMPHOMA, T-CELL, CUTANEOUS; PHOTOTHERAPY; SKIN; SKIN NEOPLASMS; STEM CELL TRANSPLANTATION; TREATMENT OUTCOME;

EID: 62349113957     PISSN: 10408746     EISSN: None     Source Type: Journal    
DOI: 10.1097/CCO.0b013e3283253190     Document Type: Review

References (63)

1. Kim EJ, Hess S, Richardson SK, et al. Immunopathogenesis and therapy of cutaneous T-cell lymphoma. J Clin Invest 2005; 115:798-812.
2. Hwang ST, Janik JE, Jaffe ES, Wilson WH. Mycosis fungoides and Sézary syndrome. Lancet 2008; 371:945-957. A comprehensive review of advances in understanding mycosis fungoides/Sézary syndrome pathophysiology.
3. Willemze R, Jaffe ES, Burg G, et al. WHO-EORTC classification for cutaneous lymphomas. Blood 2005; 105:3768-3785.
4. Kim YH, Liu HL, Mraz-Gernhard S, et al. Long-term outcome of 525 patients with mycosis fungoides and Sézary Syndrome: clinical prognostic factors and risk for disease progression. Arch Dermatol 2003; 139:857-866.
5. McGinnis KS, Junkins-Hopkina JM, Crawford G, et al. Low-dose oral bexarotene in combination with low-dose Interferon alfa in the treatment of cutaneous T-cell lymphoma: clinical synergism and possible immunologic mechanisms. J Am Acad Dermatol 2004; 50:375-379.
6. Zelenetz AD, Advani RH, Byrd JC, et al. Non-Hodgkin's lymphomas. J Natl Compr Cane Netw 2008; 6:356-421. These two studies [6**, 7**] outline up to date consensus recommendations for diagnosis, staging, and treatment of mycosis fungoides/Sézary syndrome.
7. Horwitz SM, Olsen EA, Duvic M, et al. Review of the treatment of mycosis fungoides and Sézary syndrome: a stage-based approach. J Natl Compr Cane Netw 2008; 6:436-442. These two studies [6*,7**] outline up to date consensus recommendations for diagnosis, staging, and treatment of mycosis fungoides/Sézary syndrome.
8. Lessin SR, Duvic M, Strober BE, et al. Testing efficacy and safety of topical nitrogen mustard in mycosis fungoides [abstract]. In: World Congress of Dermatology Meeting, 30th September-Sth October 2007; Buenos Aires, Argentina; 2007.
9. Brazzelli V, Antoninetti M, Palazzini S, et al. Narrow-band ultraviolet therapy in early-stage mycosis fungoides: study on 20 patients. Photodermatol Photoimmunol Photomed 2007; 23:229-233. This study demonstrates that although NBUVB is well tolerated and effective, the duration of response is short.
10. Kontos AP, Kerr HA, Malick F, et al. 308-nm excimer laser for the treatment of lymphomatoid papulosis and stage IA mycosis fungoides. Photodermatol Photoimmunol Photomed 2006; 22:168-171.
11. Meisenheimer JL. Treatment of mycosis fungoides using a 308-nm excimer laser: two case studies. Dermatol Online J 2006; 12:11.
12. Passeron T, Zakaria W, Ostovari N, et al. Efficacy of the 308-nm excimer laser in the treatment of mycosis fungoides. Arch Dermatol 2004; 140:1291-1293.
13. Passeron T, Angeli K, Cardot-Leccia N, et al. Treatment of mycosis fungoides by 308 nm excimer laser: a clinical and histological study in 10 patients]. Ann Dermatol Venereol 2007; 134 (3 Pt 1):225-231. This study provides the treatment details of using excimer laser in mycosis fungoides, a promising treatment for lesions in anatomic areas difficult to treat with topicals/phototherapy.
14. Recio ED, Zambrano B, Alonso ML, et al. Topical 5-aminolevulinic acid photodynamic therapy for the treatment of unilesional mycosis fungoides: a report of two cases and review of the literature. Int J Dermatol 2008; 47:410-413. An updated review of PDT in mycosis fungoides/Sézary syndrome as perhaps a more 'targeted' skin-directed therapy than traditional phototherapy.
15. MacCormack MA. Photodynamic therapy. Adv Dermatol 2006; 22:219-258.
16. Zane C, Venturini M, Sala R, et al. Photodynamic therapy with methylamino-levulinate as a valuable treatment option for unilesional cutaneous T-cell lymphoma. Photodermatol Photoimmunol Photomed 2006; 22:254-258.
17. Taub AF. Photodynamic therapy: other uses. Dermatol Clin 2007; 25:101-109.
18. Funk A, Hensley F, Krempien R, et al. Palliative total skin electron beam therapy (TSEBT) for advanced cutaneous T-cell lymphoma. Eur J Dermatol 2008; 18:308-312. This study demonstrates how palliative TSEBT has good clinical RR in a refractory, advanced-stage patient population.
19. Jones G, Wilson LD, Fox-Goguen L. Total skin electron beam radiotherapy for patients who have mycosis fungoides. Hematol Oncol Clin North Am 2003; 17:1421-1434.
20. Jones GW, Kacinski BM, Wilson LD, et al. Total skin electron radiation in the management of mycosis fungoides: consensus of the European Organization for Research and Treatment of Cancer (EORTC) Cutaneous Lymphoma Project Group. J Am Acad Dermatol 2002; 47:364-370.
21. Roberge D, Muanza T, Blake G, et al. Does adjuvant alpha-interferon improve outcome when combined with total skin irradiation for mycosis fungoides? Br J Dermatol 2007; 156:57-61. A combination of low-dose biological systemic treatment with total skin irradiation surprisingly does not improve CR rate or overall or disease-free survival.
22. Introcaso CE, Micaily B, Richardson SK, et al. Total skin electron beam therapy may be associated with improvement of peripheral blood disease in Sézary syndrome. J Am Acad Dermatol 2008; 58:592-595.
23. Kamstrup MR, Specht L, Skovgaard GL, Gniadecki R. A prospective, open-label study of low-dose total skin electron beam therapy in mycosis fungoides. Int J Radiat Oncol Biol Phys 2008; 71:1204-1207. This study demonstrates that low dose TSEBT has poorer clinical responses than traditional dosing regimens.
24. Tsirigotis P, Pappa V, Papageorgiou S, et al. Extraoorporeal photopheresis in combination with bexarotene in the treatment of mycosis fungoides and Sézary syndrome. Br J Dermatol 2007; 156:1379-1381.
25. Straus DJ, Duvic M, Kuzel T, et al. Results of a phase II trial of oral bexarotene (Targretin) combined with Interferon alfa-2b (Intron-A) for patients with cutaneous T-cell lymphoma. Cancer 2007; 109:1799-1803.
26. Avilés A, Nambo MJ, Neri N, et al. Interferon and low dose methotrexate improve outcome in refractory mycosis fungoides/Sézary syndrome. Cancer Biother Radiopharm 2007; 22:836-840.
27. Urosevic M. Drug evaluation: TG-1042, an adenovirus-mediated IFNgamma gene delivery for the intratumoral therapy of primary cutaneous lymphomas. Curr Opin Investig Drugs 2007; 8:493-498.
28. Olsen E, Duvic M, Frankel A, et al. Pivotal phase III trial of two dose levels of denileukin diftitox for the treatment of cutaneous T-cell lymphoma. J Clin Oncol 2001; 19:376-388.
29. Carretero-Margolis CD, Fivenson DP. A complete and durable response to denileukin diftitox in a patient with mycosis fungoides. J Am Acad Dermatol 2003; 48:275-276.
30. Kazin R, Bujanauskas P, Vonderheid EC. Durable complete remission of mycosis fungoides following erythroderma induced by denileukin diftitox. J Am Acad Dermatol 2008; 58 (2 Suppl):S31-S32.
31. Duvic M, Talpur R. Optimizing denileukin diftitox (Ontak) therapy. Future Oncol 2008; 4:457-489. These three studies [31*-33*] highlight rare, but serious adverse events observed with denileukin diftitox therapy.
32. Park M, Liu GT, Piltz-Seymour J, et al. Vision loss following denileukin diftitox treatment: a case report of possible posterior ischemic optic neuropathy. Leuk Lymphoma 2007; 48:808-811. These three studies [31*-33*] highlight rare, but serious adverse events observed with denileukin diftitox therapy.
33. Avarbock AB, Loren AW, Park JY, et al. Lethal vascular leak syndrome after denileukin diftitox administration to a patient with cutaneous gamma/delta T-cell lymphoma and occult cirrhosis. Am J Hematol 2008; 83:593-595. These three studies [31*-33*] highlight rare, but serious adverse events observed with denileukin diftitox therapy.
34. Ghori F, Polder KD, Pinter-Brown LC. Thyrotoxicosis after denileukin diftitox therapy in patients with mycosis fungoides. J Clin Endocrinol Metab 2006; 91:2205-2208.
35. Foss F. Clinical experience with denileukin diftitox (ONTAK). Semin Oncol 2006; 33 (1 Suppl 3):S11-S16.
36. Chin KM, Foss FM. Biologic correlates of response and survival in patients with cutaneous T-cell lymphoma treated with denileukin diftitox. Clin Lymphoma Myeloma 2006; 7:199-204.
37. Foss F, Demierre MF, DiVenuti G. A phase-1 trial of bexarotene and denileukin diftitox in patients with relapsed or refractory cutaneous T-cell lymphoma. Blood 2005; 106:454-457.
38. Vidulich K, Jones D, Duvic M. Cutaneous gamma/delta T-cell lymphoma treated with radiation and denileukin diftitox. Clin Lymphoma Myeloma 2008; 8:55-58. These two studies [38*,39*] show efficacy of denileukin diftitox in nonmycosis fungoides subtypes of CTCL, which often are refractory to many treatments.
39. Hathaway T, Subtil A, Kuo P, Foss F. Efficacy of denileukin diftitox in subcutaneous panniculitis-like T-cell lymphoma. Clin Lymphoma Myeloma 2007; 7:541-545. These two studies [38*,39*) show efficacy of denileukin diftitox in nonmycosis fungoides subtypes of CTCL, which often are refractory to many treatments.
40. Xu WS, Parmigiani RB, Marks PA. Histone deacetylase inhibitors: molecular mechanisms of action. Oncogene 2007; 26:5541-5552.
41. Olsen EA, Kim YH, Kuzel TM, et al. Phase lib multicenter trial of vorinostat in patients with persistent, progressive, or treatment refractory cutaneous T-cell lymphoma. J Clin Oncol 2007; 25:3109-3115. This study summarizes the results from the pivotal clinical trial that led to FDA approval of vorinostat for CTCL - the only other FDA-approved oral agent apart from bexarotene.
42. Duvic M, Vu J. Vorinostat: a new oral histone deacetylase inhibitor approved for cutaneous T-cell lymphoma. Expert Opin Investig Drugs 2007; 16:1111-1120.
43. Piekarz RL, Robey RW, Zhan Z, et al. T-cell lymphoma as a model for the use of histone deacetylase inhibitors in cancer therapy: impact of depsipeptide on molecular markers, therapeutic targets, and mechanisms of resistance. Blood 2004; 103:4636-4643.
44. Kim YH, Whittaker S, Demierre MF, et al. Clinically Significant responses achieved with romidepsin in treatment-refractory cutaneous T-cell lymphoma: final results from a phase 2B, international, multicenter, registration study [abstract #10225], In: American Society of Hematology Annual Meeting, 6-9 December 2008; San Francisco, California, USA; 2007. This abstract summarizes the pivotal phase IIb trial for romidepsin, an intravenously administered HDAC inhibitor, with likely more potent clinical effects (and side-effect profile) than vorinostat.
45. Bates SE, Piekarz RL Histone deacetylase inhibitors in combinations: will the preclinical promises be kept? Cancer J 2007; 13:80-83.
46. Gardner J, Introcaso CE, Nasta SD, et al. A novel regimen of vorinostat with interferon gamma for refractory Sézary syndrome. J Am Acad Dermatol (in press).
47. Geskin L, Vorinostat in combination treatment for cutaneous T-cell lymphoma [abstract #30]. In: EORTC Cutaneous Lymphoma Task Force Clinical Meeting, 5-7 September 2008; Copenhagen, Denmark; 2008.
48. Dummer R, Hymes K, Sterry W, et al. Phase I trial of oral vorinostat in combination with bexarotene in advanced cutaneous T-cell lymphoma [abstract #6]. In: EORTC Cutaneous Lymphoma Task Force Clinical Meeting, 5-7 September 2008; Copenhagen, Denmark; 2008.
49. Rider DA, Havenith CE, de Ridder R, et al. A human CD4 monoclonal antibody for the treatment of T-cell lymphoma combines inhibition of T-cell signaling by a dual mechanism with potent Fc-dependent effector activity. Cancer Res 2007; 67:9945-9953.
50. Kim YH, Duvic M, Obritz E, et al. Clinical efficacy of zanolimumab (HuMax-CD4): two phase 2 studies in refractory cutaneous T-cell lymphoma. Blood 2007; 109:4655-4662. This study shows impressive clinical response and durability of response in these preliminary phase II clinical trials for an anti-CD4 mAb.
51. Ruuls SR, Lammerts van Bueren JJ, van de Winkel JG, Parren PW. Novel human antibody therapeutics: the age of the Umabs. Biotechnol J 2008; 3:1157-1171.
52. Bernengo MG, Quaglino P, Comessatti A, et al. Low-dose intermittent alemtuzumab in the treatment of Sezary syndrome: clinical and immunologic findings in 14 patients. Haematologica 2007; 92:784-794. An important study demonstrating preliminary efficacy and safety (i.e. less infections) of low-dose regimen in Sézary syndrome patients.
53. Alinari L, Geskin L, Grady T, et al. Subcutaneous alemtuzumab for Sezary syndrome in the very elderly. Leuk Res 2008; 32:1299-1303.
54. Dearden C. The role of alemtuzumab in the management of T-cell malignancies. Semin Oncol 2006; 33 (2 Suppl 5):S44-S52.
55. Duvic M, Foss FM. Mycosis fungoides: pathophysiology and emerging therapies. Semin Oncol 2007; 34 (6 Suppl 5):S21-S28.
56. Duvic M, Olsen EA, et al. Intravenous forodesine (BCX-1777), a novel purine nucleoside phosphorylase (PNP) inhibitor, demonstrates clinical activity in patients with refractory cutaneous T-cell lymphoma [abstract]. Blood 2004; 104:683a.
57. Duvic MZS, Olsen F EA, et al. Phase I-II multicenter study of intravenous Bcx-1777 in patients with refractory cutaneous T-cell lymphoma [abstract]. Proc Am Soc Clin Oncol 2004; 22:613a.
58. Molina A, Zain J, Arber DA, et al. Durable clinical, cytogenetic, and molecular remissions after allogeneic hematopoietic cell transplantation for refractory Sezary syndrome and mycosis fungoides. J Clin Oncol 2005; 23:6163-6171.
59. Introcaso CE, Leber B, Greene K, et al. Stem cell transplantation in advanced cutaneous T-cell lymphoma. J Am Acad Dermatol 2008; 58:645-649. A review of refractory CTCL treated with allogeneic HSCT (effective) and autologous HSCT (not effective).
60. Bigler RD, Crilley P, Micaily B, et al. Autologous bone marrow transplantation for advanced stage mycosis fungoides. Bone Marrow Transplant 1991; 7:133-137.
61. Olavarria E, Child F, Woolford A, et al. T-cell depletion and autologous stem cell transplantation in the management of tumour stage mycosis fungoides with peripheral blood involvement. Br J Haematol 2001; 114: 624-631.
62. Herbert KE, Spencer A, Grigg A, et al. Graft-versus-lymphoma effect in refractory cutaneous T-cell lymphoma after reduced-intensity HLA-matched sibling allogeneic stem cell transplantation. Bone Marrow Transplant 2004; 34:521-525.
63. Duarte RF, Schmitz N, Servitje O, Sureda A. Haematopoietic stem cell transplantation for patients with primary cutaneous T-cell lymphoma. Bone Marrow Transplant 2008; 41:597-604.