Bexarotene in the treatment of cutaneous T-cell lymphoma.
Primary cutaneous T-cell lymphomas encompass a spectrum of non-Hodgkin's lymphomas that are characterised by clonal proliferation of skin-homing malignant T lymphocytes. Mycosis fungoides and the leukaemic variant Sézary syndrome, collectively referred to as cutaneous T-cell lymphomas, are the most common entities. No curative therapy exists and patients ultimately develop advanced or relapsed disease that is refractory to standard treatment options. Therefore, there is a great need for the development of novel emerging therapies. Bexarotene is the first synthetic nuclear retinoid X receptor-selective retinoid approved by the FDA for the treatment of refractory cutaneous T-cell lymphoma in all stages, as both an oral capsule and a topical gel formulation. Bexarotene was found to induce apoptosis in a variety of preclinical in vitro and in vivo models including cutaneous T-cell lymphoma cells, and has shown efficacy in two multi-centre, open-label Phase II - III clinical trials for early and advanced stages of cutaneous T-cell lymphoma in patients who have failed or were refractory to standard therapies. New insights into the immunomodulatory function of bexarotene have indicated opportunities for combined treatment with IFN-alpha, denileukin diftitox or phototherapy. This article reviews the biological properties, pharmacokinetics, clinical efficacy, safety and role of bexarotene in the treatment of cutaneous T-cell lymphoma.
Querfeld
Christiane
C
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. c-querfeld@northwestern.edu
Nagelli
Lakshmi V
LV
Rosen
Steven T
ST
Kuzel
Timothy M
TM
Guitart
Joan
J
D000818:Animals; D000970:Antineoplastic Agents / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000145:classification / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000145:classification / Q000188:drug therapy*
D000970:Antineoplastic Agents