What are the novel therapies for cutaneous T-cell lymphoma (CTCL)?

Updated: Aug 15, 2018
  • Author: Lauren C Pinter-Brown, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Novel therapies for cutaneous T-cell lymphoma include bexarotene, which has demonstrated efficacy in advanced refractory cases of the disease. Other novel agents include the following:

  • IL-2 fusion toxin (Ontak)

  • IL-12

  • Pentostatin (a potent adenosine deaminase inhibitor)

  • Forodesine

  • Gemcitabine [130]

  • Histone deacetylase inhibitors (eg, romidepsin, [131] depsipeptide)

  • NF-kappa-B inhibitors

  • Cytokine-receptor antagonists

  • Immunomodulatory therapies

  • Allogeneic stem cell therapy

  • Mogamulizumab [105]

Mogamulizumab was approved by the FDA in August 2018 for adults with 2 rare forms of CTCL (ie, mycosis fungoides, Sézary syndrome).

Forodesine is a potent inhibitor of purine nucleoside phosphorylase that promotes apoptosis in T- and B- cells through intracellular accumulation of deoxyguanosine triphosphate. In a phase II study of oral forodesine therapy in 144 patients with CTCL who had already failed three or more systemic therapies, no patients achieved complete remission but 11% achieved partial remission and 50% had stabilization of disease. [132]

The value of new therapeutic approaches to cutaneous T-cell lymphoma needs to be critically assessed with regard to overall survival and disease-specific survival.


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