Bexarotene--an alternative therapy for progressive cutaneous T-cell lymphoma? First experiences.

Abstract

BACKGROUND:

A standard therapy for advanced cutaneous T-cell lymphomas has not yet been defined. Bexarotene is a new retinoid x receptor-specific retinoid that has been approved for systemic second-line therapy for cutaneous T-cell lymphomas in the USA and Europe. In order to evaluate the efficacy of bexarotene in cutaneous T-cell lymphomas, a pilot trial was initiated.

PATIENTS AND METHODS:

In a pilot project 10 patients with advanced cutaneous T-cell lymphomas, who had received a variety of previous treatments, were treated with bexarotene at the departments of dermatology in Münster, Minden and Charité Berlin, Germany. The patients received bexarotene at a dose of 300 mg/m2 body surface daily. According to the percentage of tumour reduction and affected body surface, the response rates were divided in complete and partial remission, stable disease and progressive disease. Laboratory parameters i.e. cholesterol, triglycerides transaminases, T3, T4, and TSH were screened regularly.

RESULTS:

In 2 patients a short partial remission was achieved; however, after a few weeks progression followed. In 4 patients a lasting stabilisation was obtained. The other 4 patients showed a progressive disease during therapy. 6 patients developed hypertriglyceridemia with levels up to 2000 mg/dl; therapy had to be suspended in 3 patients because of these adverse drug events.

CONCLUSION:

Weighing benefits and risks, bexarotene can at present not be recommended as standard therapy in the treatment of patients with progressive cutaneous lymphomas.

• Authors: J Bohmeyer, R Stadler, A Kremer, D Nashan, M Muche, S Gellrich, T Luger, W Sterry
• Journal: Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (J Dtsch Dermatol Ges) Vol. 1 Issue 10 Pg. 785-9 (Oct 2003) ISSN: 1610-0379 [Print] Germany
• PMID: 16281814 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Chemical References

• Aminoquinolines
• Anticarcinogenic Agents
• Antineoplastic Agents
• Immunosuppressive Agents
• Tetrahydronaphthalenes
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Interferons
• Bexarotene
• Imiquimod
• Prednisone
• Tacrolimus

Topics

• Adult
• Aged
• Aminoquinolines (therapeutic use)
• Anticarcinogenic Agents (administration & dosage, adverse effects, therapeutic use)
• Antineoplastic Agents
• Antineoplastic Combined Chemotherapy Protocols
• Bexarotene
• Combined Modality Therapy
• Cyclophosphamide
• Disease Progression
• Doxorubicin
• Female
• Humans
• Imiquimod
• Immunosuppressive Agents (therapeutic use)
• Interferons (therapeutic use)
• Lymphoma, T-Cell, Cutaneous (drug therapy, pathology, radiotherapy)
• Male
• Middle Aged
• Neoplasm Staging
• PUVA Therapy
• Pilot Projects
• Prednisone
• Remission Induction
• Skin (pathology)
• Skin Neoplasms (drug therapy, pathology, radiotherapy)
• Tacrolimus (therapeutic use)
• Tetrahydronaphthalenes (administration & dosage, adverse effects, therapeutic use)
• Time Factors
• Treatment Outcome
• Vincristine