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


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.


CONCLUSIONS
Weighing benefits and risks, bexarotene can at present not be recommended as standard therapy in the treatment of patients with progressive cutaneous lymphomas.
Bohmeyer
J
J
Department of Dermatology, Medical Centre Minden.
Stadler
R
R
Kremer
A
A
Nashan
D
D
Muche
M
M
Gellrich
S
S
Luger
T
T
Sterry
W
W
D000328:Adult; D000368:Aged; D000634:Aminoquinolines / Q000627:therapeutic use; D016588:Anticarcinogenic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents; D000971:Antineoplastic Combined Chemotherapy Protocols; D000077610:Bexarotene; D003131:Combined Modality Therapy; D003520:Cyclophosphamide; D018450:Disease Progression; D004317:Doxorubicin; D005260:Female; D006801:Humans; D000077271:Imiquimod; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007372:Interferons / Q000627:therapeutic use; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011701:PUVA Therapy; D010865:Pilot Projects; D011241:Prednisone; D012074:Remission Induction; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D016559:Tacrolimus / Q000627:therapeutic use; D013764:Tetrahydronaphthalenes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014750:Vincristine
D000634:Aminoquinolines; D016588:Anticarcinogenic Agents; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D013764:Tetrahydronaphthalenes; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D007372:Interferons; D000077610:Bexarotene; D000077271:Imiquimod; D011241:Prednisone; D016559:Tacrolimus