title: Pralatrexate (Folotyn).
abstract: T-cell lymphoma accounts for 10% to 15% of all cases of non-Hodgkin lymphoma in the United States (approximately 5000 to 6000 cases a year). Peripheral T-cell lymphoma (PTCL) comprises a subgroup of rare and aggressive non-Hodgkin lymphomas that develop from T cells in different stages of maturity outside of the thymus. Cutaneous T-cell lymphoma is a subgroup that falls within the T-cell lymphoma population but is classified differently than other PTCLs. Most cases of CTCL are considered indolent and can often be treated with less aggressive therapies. Eight percent to 55% of CTCL cases undergo transformation, and once this transformation occurs, the disease acts similarly to other PTCLs and its classification changes to that of a PTCL. Transformed CTCL requires aggressive systemic therapy. Pralatrexate is the first Food and Drug Administration-approved drug for relapsed and refractory PTCL and has also gained compendia approval for treatment of CTCL. Pralatrexate is an antifolate chemotherapeutic inhibitor of dihydrofolatereductase. It has a high affinity for the one carbon-reduced folate carrier, which leads to better cellular internalization of the drug and has a greater antitumor effect than methotrexate. Several clinical trials have been conducted to evaluate the use of this drug in PTCL and other malignancies such as non-small cell lung cancer. This review offers focused information for dermatologists about pralatrexate and its use as a novel treatment for relapsed or refractory PTCL.
authors.affiliation: Department of Medicine, Baylor University Medical Center, Dallas, TX, USA.
authors.forename: William
authors.initials: W
authors.lastname: Abramovits
authors.forename: Marcial
authors.initials: M
authors.lastname: Oquendo
authors.forename: Patricia
authors.initials: P
authors.lastname: Granowski
authors.forename: Aditya
authors.initials: A
authors.lastname: Gupta
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cather
mesh_terms: D000630:Aminopterin / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D005493:Folic Acid Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D016399:Lymphoma, T-Cell / Q000188:drug therapy*; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy*; D016411:Lymphoma, T-Cell, Peripheral / Q000188:drug therapy
chemical_list: C418863:10-propargyl-10-deazaaminopterin; D005493:Folic Acid Antagonists; D000630:Aminopterin