Current treatment strategies and emerging therapies for cutaneous lymphoma

Abstract

Primary cutaneous lymphomas are defined as non-Hodgkin lymphomas presenting in the skin with no evidence of extracutaneous disease at the time of diagnosis. Primary cutaneous lymphoma includes a heterogeneous group of cutaneous T-cell lymphomas (CTCL) and cutaneous B-cell lymphomas (CBCL). 1 In Japan, 74.9% of primary cutaneous lymphomas are CTCL, which is much higher than the proportion of CBCL (21.1%). Among CTCL, mycosis fungoides (MF) accounts for the majority at 48.0%, followed by primary cutaneous CD30-positive lymphoproliferative disorders (9.4%), adult T-cell leukemia/lymphoma (ATL, 8.5%) and peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS, 6.5%). 2 In recent years, many new therapeutic agents have been developed to treat cutaneous lymphomas, especially CTCL. Some of these agents were developed in Japan or approved in Japan prior to approval in Europe or the USA. Therefore, many therapeutic agents are currently available in Japan.This review summarizes the current treatment strategies for cutaneous lymphomas, especially CTCL, and emerging therapies for MF, Sézary syndrome (SS), primary cutaneous anaplastic large cell lymphoma (pcALCL), ATL, and CBCL. | CURRENT THER APEUTI C S TR ATEG IE S FOR CUTANEOUS LYMPHOMAPreviously, for early stage MF or SS, topical corticosteroids, ultraviolet (UV) irradiation, oral etretinate, or a combination thereof, was initially used. In resistant cases, interferon (IFN) was administered. Single-agent or combination chemotherapy was selected for advanced disease. Local radiotherapy (RT) was performed for local tumors. Over the last decade, several new agents have been introduced, which has expanded treatment options.Recently, topical therapy or UV irradiation, which are skindirected therapies (SDT), has been selected as initial treatment for early stage MF or SS. RT is a type of SDT that is used to treat treatment-resistant plaques and tumors. SDT is used in early stages and also in advanced stages in combination with systemic therapies.

Nano-Based Approved Pharmaceuticals for Cancer Treatment: Present and Future Challenges

“…However, other approaches attempt to improve the production or enhance the potency of Ontak TM -derived immunotoxins. Some T-cell malignancies overexpress IL2R, making it an ideal target for immunotoxins [ 100 ]. Recently, the development of monovalent and bivalent human IL-2 fusion toxins targeting human CD25 + cells using an advanced, unique diphtheria-toxin-resistant yeast Pichia Pastor-is expression system was reported, showing potent and selective binding affinity to cells expressing high-affinity IL-2R [ 99 ].…”