Emerging drugs for the treatment of cutaneous T-cell lymphoma

ABSTRACT

Introduction

Cutaneous T cell lymphoma (CTCL) is a rare and incurable group of non-Hodgkin lymphomas that manifest as patches, plaques, tumors, and/or erythroderma in the skin. Standard skin-directed therapies for CTCL are effective in patients with indolent early-stage disease, but more advanced/refractory stage patients require systemic therapies. However, none of the treatments are considered curative and most patients suffer from relapses. Biologic therapies and immunotherapy provide novel treatment options for patients with advanced or refractory disease.

Areas covered

This review provides a discussion of recently approved biological and novel therapeutics that are actively developed for the management of the heterogeneous group of CTCL.

Expert opinion

Mogamulizumab and brentuximab vedotin have reached the market and are approved for the treatment of CTCL, providing valuable options. Additionally, therapies utilizing immune checkpoint inhibitors, miRNA inhibitors, and peptide inhibitors show promising results in clinical trials. Durvalumab, pembrolizumab, TTI-621, BNZ-1, and MRG-106 are several of the emerging treatments still in trials. Further combinatorial studies are needed as none of the treatments have demonstrated long-term remissions.

KEYWORDS:

• Cutaneous T cell lymphoma
• CTCL
• antagomir-155
• anti-CCR4
• anti-CD47
• brentuximab-vedotin
• cobomarsen
• durvalumab
• miRNA inhibitors
• mogamulizumab
• PD1/PD-L1 blockade
• pembrolizumab
• peptide inhibitors
• TTI-621
• KIR3DL2

Declaration of interest

J Zain: Consultant - Kyowa Kirin, Seattle Genetics, Verastem, Daichi Seiko, Mundi Pharma. Speakers Bureau - Seattle Genetics, Secure Bio, Daichi Seiko, Abbvie. Research Support - Seattle Genetics, Secure Bio, Daichi Seiko, Abbvie. ST Rosen: Consultant - PeproMene Bio, Exicure, Apotex/Apobiologix, PharmaGene, Trillium, Verastem. Educational Advisory Board - NeoGenomics, PeproMene Bio. Stock Options - PeproMene Bio, Exicure, Trillium, January Therapeutics. C Querfeld: Consultant - Helsinn, Kyowa Kirin, Stemline Therapeutics, Bioniz, Almirall, MiRagen, Trillium. Speakers Bureau - Helsinn. Research Support - Celgene. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This research was funded in part through the NIH/NCI Cancer Center Support Grant (P30CA033572) to the City of Hope, the NIH/NCI grant (R01 CA229510-01) and Leukemia Lymphoma Society Clinical Scholar Award to C. Querfeld in the capacity of mentoring co-author.