title: Polish Lymphoma Research Group Experience With Bexarotene in the Treatment of Cutaneous T-Cell Lymphoma.
abstract: Bexarotene, a synthetic retinoid licensed for the treatment of refractory cutaneous T-cell lymphoma (CTCL), has been used clinically in Poland since 2007 in 21 patients. The objective of our retrospective, multicenter study was to evaluate our experience with bexarotene therapy, including efficacy, safety, and survival outcomes. We retrospectively identified 21 adult patients who were treated with bexarotene between the years 2007 and 2012. Starting dose of bexarotene was 300 mg/m per day. The analysis included 3 patients with early-stage mycosis fungoides (MF), 16 patients with advanced-stage MF, and 2 patients with Sézary syndrome (SS). The mean duration of therapy with bexarotene was 14.5 months. Use of bexarotene resulted in an overall response rate of 81.0%, although the overall mortality rate was 52.8%. In our study, early-stage CTCL responded better than advanced-stage CTCL (100.0% vs. 77.8%, respectively). The mean time to observable response was 1.8 months, and the mean duration of the response was 16.4 months. Most significant side effects were hyperlipidemia, hypothyroidism, and a bleeding gastric ulcer. Based on the results of our analysis, bexarotene is a valuable tool in the treatment of refractory early-stage CTCL. Although a majority of patients initially responded to therapy, the high mortality rate in the advanced-stage group suggests that bexarotene does not completely resolve the therapeutic problems in all stages of CTCL. Patient stratification for bexarotene treatment may need a thorough reassessment, in that bexarotene may not be an effective drug in the very advanced stages of CTCL.
authors.affiliation: 1Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland; 2Department of Internal Medicine, New York Medical College, Valhalla, NY; 3Department of Propedeutic Oncology, Medical University of Gdansk, Gdansk, Poland; 4Department of Oncology, Center of Oncology of Professor Franciszek Lukaszczyk, Bydgoszcz, Poland; 5Department of Hematology, Collegium Medicum of the Jagiellonian University, Krakow, Poland; 6Department of Oncology, University of Warmia and Mazury, Olsztyn, Poland; 7Department of Hematology, Medical University of Gdansk, Gdansk, Poland; 8Department of Lymphoid Malignancies, Maria Sklodowska-Curie Institute and Oncology Center, Warsaw, Poland; 9Department of Dermatology, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland; 10Department of Dermatology, University of Warmia and Mazury, Olsztyn, Poland; 11Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Sokolowska-Wojdylo
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Florek
authors.forename: Jan Maciej
authors.initials: JM
authors.lastname: Zaucha
authors.forename: Ewa
authors.initials: E
authors.lastname: Chmielowska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Giza
authors.forename: Wanda
authors.initials: W
authors.lastname: Knopinska-Posluszny
authors.forename: Waldemar
authors.initials: W
authors.lastname: Kulikowski
authors.forename: Witold
authors.initials: W
authors.lastname: Prejzner
authors.forename: Joanna
authors.initials: J
authors.lastname: Romejko-Jarosinska
authors.forename: Ewa
authors.initials: E
authors.lastname: Paszkiewicz-Kozik
authors.forename: Michal
authors.initials: M
authors.lastname: Osowiecki
authors.forename: Jan
authors.initials: J
authors.lastname: Walewski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Rogowski
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Grzanka
authors.forename: Waldemar
authors.initials: W
authors.lastname: Placek
authors.forename: Hanna
authors.initials: H
authors.lastname: Lugowska-Umer
authors.forename: Anna
authors.initials: A
authors.lastname: Kowalczyk
authors.forename: Roman
authors.initials: R
authors.lastname: Nowicki
authors.forename: Wojciech
authors.initials: W
authors.lastname: Jurczak
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016588:Anticarcinogenic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077610:Bexarotene; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced; D007037:Hypothyroidism / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy* / Q000401:mortality; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced; D011044:Poland / Q000453:epidemiology; D012176:Retinoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D012751:Sezary Syndrome / Q000188:drug therapy* / Q000401:mortality; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000401:mortality; D013276:Stomach Ulcer / Q000139:chemically induced; D013764:Tetrahydronaphthalenes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D016588:Anticarcinogenic Agents; D012176:Retinoids; D013764:Tetrahydronaphthalenes; D000077610:Bexarotene