Alitretinoin in the treatment of cutaneous T‐cell lymphoma

Abstract

Introduction In this survey, we analyzed data from patients suffering from the most common cutaneous T‐cell lymphomas (CTCLs) subtypes mycosis fungoides (MF) and Sézary syndrome (SS), treated with the retinoid alitretinoin during a 7‐year period at our outpatient department between 2015 and 2020. Materials and Methods We analyzed patient medical records including TNMB stage, side effects under therapy with alitretinoin, time to next treatment (TTNT), and previous photo documentation. Results A total of 35 patients with MF (n = 28) and SS (n = 7) were included in the study, of whom 69% were male and 31% were female. The mean age of onset was 56 ± 15 years in MF and 65.4 ± 10.8 years in SS with 51.4% having early stage (IA–IIA) and 48.6% having advanced stage (IIB–IVA) CTCL. Of these patients 37.2% responded to alitretinoin, 28.6% had a stable course, and 34.3% experienced progression. Alitretinoin was administered as a monotherapy (25.7%) or combined with five concomitant therapies (74.2%), most frequently with ECP (31.4%) and PUVA (11.4%). 63% did not report any side effects, most often hypertriglyceridemia (20%) was described. Conclusion Considering that nearly two thirds of the CTCL patients treated with alitretinoin showed a response or stable disease, together with a low number of side effects and low cost compared to bexarotene, alitretinoin may be a potential alternative in the treatment of less advanced CTCLs. This survey represents the largest number of recorded therapies with the retinoid alitretinoin in CTCLs in a European patient collective.

Efficacy of Oral Alitretinoin in Treatment of Mycosis Fungoides Palmaris et Plantaris

“…The use of retinoids for the treatment of CTCLs is well established. In previous retrospective studies investigating alitretinoin treatment in CTCLs, response rates were reported to be favourable, and side-effects were minimal ( 4 – 6 ). Overall, alitretinoin demonstrated efficacy in treating MFPP, as it exhibited a significant improvement in disease severity ( Fig.…”

“…Oral bexarotene, the only approved retinoid for the treatment of cutaneous T-cell lymphomas (CTCLs), has a high frequency of adverse effects and is unavailable in certain countries, including Korea. Oral alitretinoin, approved for chronic recalcitrant hand eczema with positive outcomes and minimal side-effects, ( 2 , 3 ) has shown promising results in the treatment of MF ( 4 – 6 ), as well as in MFPP ( 7 ).…”

The Use of Retinoids for the Prevention and Treatment of Skin Cancers: An Updated Review

“…Aside from bexarotene, there is a precedent to further investigate the use of other retinoid compounds to treat CTCL. One retrospective analysis examined the efficacy of oral alitretinoin for the treatment of MF and SS [ 266 , 267 ]. In one of the analyses 40 MF and 8 SS patients were recruited and were treated with 30 mg dose of oral alitretinoin achieving moderate success [ 266 ].…”

“…In one of the analyses 40 MF and 8 SS patients were recruited and were treated with 30 mg dose of oral alitretinoin achieving moderate success [ 266 ]. Based on these findings, Alitretinoin is used in select counties where bexarotene is not available (e.g., Canada) as an off-label treatment for CTCL [ 267 ]. The cost of alitretinoin is significantly cheaper in comparison to bexarotene.…”

Successful treatment of chronic actinic dermatitis with alitretinoin: Should retinoids be included in the therapeutical arsenal?

“…the constatation of its efficacy in pathologies ranging from mycosis fungoides and cutaneous T-cell lymphomas8 to prurigo nodularis,9 hypertrophic lichen planus 10. This pan-retinoid achieves an immune modulation through the activation of the three isoforms (alfa, beta, gamma) of both the RAR and RXR intranuclear receptors.…”