Advances in the pharmacological management of cutaneous T-cell lymphoma

Expert Opin Pharmacother. 2024 May;25(7):885-894. doi: 10.1080/14656566.2024.2360646. Epub 2024 Jun 3.

Abstract

Introduction: Current treatment guidelines for cutaneous T cell lymphoma (CTCL) advocate a stage-driven approach, considering clinical presentation, symptom burden, and patient comorbidities. Therapy selection hinges on factors like disease subtype, severity, and treatment availability. The primary goal is to enhance the quality of life by mitigating symptoms, as achieving lasting complete remission is infrequent.

Areas covered: Over the past decade (2013-2023), the therapeutic landscape of CTCL has experienced substantial transformation with the introduction of innovative therapies. This review explores the main pivotal developments in traditional treatment schedules and recently introduced drugs, aiming to offer clinicians and researchers a thorough perspective on the decade's progress in the field.

Expert opinion: Despite the progress made in CTCL therapeutics, ranging from topical chemotherapeutics to immunomodulatory agents, several unmet needs persist. Firstly, there is a pressing need for the incorporation of readily available predictors for treatment response, encompassing clinical, pathological, and molecular features. Secondly, a more profound comprehension of the tumor microenvironment is imperative to optimize the landscape of targetable molecules. Lastly, the undertaking of studies on combination regimens should be encouraged as it enhances therapy efficacies by synergistically combining agents with diverse modes of action.

Keywords: CTCL; Cutaneous lymphoma; Sèzary syndrome; TSEBT; brentuximab; lacutamab; mogamulizumab; mycosis fungoides.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents* / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Humans
  • Immunomodulating Agents / therapeutic use
  • Lymphoma, T-Cell, Cutaneous* / drug therapy
  • Lymphoma, T-Cell, Cutaneous* / pathology
  • Neoplasm Staging
  • Practice Guidelines as Topic
  • Quality of Life*
  • Skin Neoplasms* / drug therapy
  • Skin Neoplasms* / pathology
  • Tumor Microenvironment* / drug effects

Substances

  • Antineoplastic Agents
  • Immunomodulating Agents