Pralatrexate: evaluation of clinical efficacy and toxicity in T-cell lymphoma

Abstract

Introduction: Pralatrexate is a novel antifolate agent that belongs to the class of 10-deazaaminopterins. Its clinical efficacy as a single agent in relapsed or refractory peripheral T-cell lymphoma (PTCL) has been established in randomized trials. Treatment with this agent is generally safe.

Areas covered: This paper discusses the pharmacokinetics and efficacy of pralatrexate in T-cell lymphoma in clinical trials. In addition, the authors highlight pralatrexate-associated adverse effects and safety concerns.

Expert opinion: Although established as a second-line therapy, pralatrexate offers a clinical benefit to less than one-third of patients with PTCL. In addition, toxicity of this agent can be significant, especially mucositis, immunosuppression and thrombocytopenia. Currently, the potential synergy between pralatrexate and other agents in T-cell lymphoma is being explored in a number of studies. These results will hopefully prove the validity of this approach, leading to improved quantity of life in these patients, with an acceptable comfort index.

Keywords::

• chemotherapy
• folate antagonist
• PDX
• peripheral T-cell lymphoma
• pralatrexate
• PROPEL
• PTCL