Potentials of brentuximab vedotin in the treatment of relapse/refractory cutaneous T-cell lymphomas: literature review and authors’ observation

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Abstract

Primary cutaneous T-cell lymphomas encompass a heterogeneous group of T-cell lymphoproliferative disorders developing primarily in the skin and characterized by a number of specific diagnostic, clinical, and therapeutic features. Mycosis fungoides accounts for more than half of all cutaneous lymphoma cases, while CD30+ lymphoproliferative diseases of the skin (primary cutaneous anaplastic large-cell lymphoma and lymphomatoid papulosis) constitute one-fourth of them and the remaining cases are rare tumour types, including primary cutaneous peripheral T-cell lymphoma, unspecified/not otherwise specified.

Activation antigen СD30 is a cell membrane glycoprotein of the tumour necrosis factor family. More than 75 % of primary cutaneous CD30-positive lymphoma cells express CD30; it may be detected in other diseases as well, but to a lesser extent.

Most patients with cutaneous CD30+ lymphoproliferative diseases have indolent disease and a favourable prognosis; resistant disease is observed in approximately 30 % of sufferers, and fatal outcomes occur in 8 % of cases [1].

Systemic immunomodulatory therapy or chemotherapy is often used in advanced disease. Monoclonal antibodies were recently introduced into clinical practice for the treatment of cutaneous lymphomas. One of these agents is brentuximab vedotin, a CD30-monoclonal antibody conjugated to monomethyl auristatin E.

We present two case reports: one of frequently recurring lymphomatoid papulosis and the other of refractory primary cutaneous peripheral T-cell lymphoma, unspecified/not otherwise specified. Targeted therapy with brentuximab vedotin, either alone or in combination with chemotherapy, resulted in a sustained, long-lasting remission in both cases.

About the authors

L. G. Gorenkova

National Research Center for Hematology, Ministry of Health of the Russian Federation

Author for correspondence.
Email: l.aitova@mail.ru
ORCID iD: 0000-0002-3967-9183

Liliya G. Gorenkova — Cand. Sci. (Med.), Researcher of the Department of Intensive High-dose Chemotherapy for Hemoblastosis with a Hospital and Outpatient Facility

tel.: +7 (926) 600-79-09, +7 (495) 612-23-61

Россия

S. K. Kravchenko

National Research Center for Hematology, Ministry of Health of the Russian Federation

Email: kravchenko.s@blood.ru
ORCID iD: 0000-0002-7721-2074

Sergey K. Kravchenko — Cand. Sci. (Med.), Assoc. Prof., Head of the Department of Intensive High-dose Chemotherapy for Hemoblastosis with a Hospital and Outpatient Facility

tel. +7 (495) 613-24-46

Россия

I. E. Belousova

S. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation; Saint Petersburg Medico-Social Institute

Email: irena.belousova@mail.ru
ORCID iD: 0000-0002-4374-4435

Irena E. Belousova — Dr. Sci. (Med.), Prof. of the Department of Skin and Venereal Diseases

Prof. of the Department of Pathological Anatomy

Россия

References

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  2. Willemze R., Jaffe E. S., Burg G., Cerroni L., Berti E., Swerdlow S. H. et al. WHO-EORTC classification for cutaneous lymphomas. Blood. 2005;105(10):3768–3785.
  3. Белоусова И. Э. Федеральные клинические рекомендации по ведению больных лимфомами кожи. М., 2015. [Belousova I. E. Federal clinical practice guidelines for the management of patients with lymphomas of the skin. Мoscow, 2015. (In Russ.)]
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  6. Newland K. M., McCormack C. J., Twigger R., Buelens O., Hughes C. F., Lade S. et al. The efficacy of methtotrexate for lymphomatoid papulosis. J Am Acad Dermatol. 2015;72(6):1088–1090.
  7. Enos T. H., Feigenbaum L. S., Wickless H. W. Brentuximab vedotin in CD30+ primary cutaneous T-cell lymphomas: a review and analysis of existing data. Int J Dermatol. 2017 Dec;56(12):1400–1405.
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  11. Niitsu N., Kohori M., Higashihara M., Bessho M. Phase II study of the irinotecan (CPT-11), mitoxantrone and dexamethasone regimen in elderly patients with relapsed or refractory peripheral T-cell lymphoma. Cancer Sci. 2007 Jan;98(1):109–112.
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  13. Spectrum Pharmaceuticals, Inc. Phase 1 Dose Finding Study of Belinostat Plus Cyclophosphamide/Vincristine/Doxorubicin/Prednisone (CHOP) Regimen (BelCHOP) for Treatment of Patients With Peripheral Tcell Lymphoma (PTCL). In: ClinicalTrials.gov [Internet]. Available from: http://clinicaltrials.gov/show/NCT01839097 [cited 2017 March 31].
  14. Kim Y. H., Tavallaee M., Sundram U., Salva K. A., Wood G. S., Li S. et al. Phase II investigator-initiated study of brentuximab vedotin in mycosis fungoides and Sezary syndrome with variable CD30 expression level: a multi-institution collaborative project. J Clin Oncol. 2015 Nov 10;33(32):3750–3758.

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Copyright (c) 2019 Gorenkova L.G., Kravchenko S.K., Belousova I.E.

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