Key clinical studies of systemic chemotherapy in cutaneous T-cell lymphoma
| Therapy examples* . | Efficacy . | Comments . |
|---|---|---|
| CHOP-based67 | ORR stage IIB: 66% | Myelosuppression with risk of infection; very short remission duration |
| EPOCH61 | ORR stage IIB-IV: 80% | Myelosuppression with risk of infection; short remission duration |
| CMED/ABV42,62 | ORR stage III-IV: 81% | Myelosuppression with risk of infection; median DFS of 7 months and 27% 5-year DFS |
| Pegylated liposomal doxorubicin65 | ORR stage IA-IV: 88% | Single agent; well tolerated; infusion-related events; no comparisons with standard anthracyclines |
| Pentostatin64 | ORR stage IIB: 75% Stage III: 58% Stage IV: 50% | Numerous trials and regimens used; activity in PTCL; perhaps best activity in SS; prolonged therapy needed in some cases; lymphopenia |
| Fludarabine plus IFN-α55 | ORR stage IIA-IVA: 58% stage IVB: 40% | Neutropenia common |
| Fludarabine plus cyclophosphamide66 | ORR stage IIB-III: 55% | Appears higher RR to fludarabine-alone; lymphopenia and prolonged myelosuppression in some patients; stem cell collection yields are lower |
| Gemcitabine63 | ORR stage IIB-III: 70% | Neutropenia; recent evidence that toxicities (rash, infection) may be higher in patients with CTCL (see “Systemic chemotherapy”) |
| 2-Chlorodeoxyadensine68 | ORR stage IIA-IV: 28% | Median duration or response of 4.5 months; bone marrow suppression and infections in 62% |
| Therapy examples* . | Efficacy . | Comments . |
|---|---|---|
| CHOP-based67 | ORR stage IIB: 66% | Myelosuppression with risk of infection; very short remission duration |
| EPOCH61 | ORR stage IIB-IV: 80% | Myelosuppression with risk of infection; short remission duration |
| CMED/ABV42,62 | ORR stage III-IV: 81% | Myelosuppression with risk of infection; median DFS of 7 months and 27% 5-year DFS |
| Pegylated liposomal doxorubicin65 | ORR stage IA-IV: 88% | Single agent; well tolerated; infusion-related events; no comparisons with standard anthracyclines |
| Pentostatin64 | ORR stage IIB: 75% Stage III: 58% Stage IV: 50% | Numerous trials and regimens used; activity in PTCL; perhaps best activity in SS; prolonged therapy needed in some cases; lymphopenia |
| Fludarabine plus IFN-α55 | ORR stage IIA-IVA: 58% stage IVB: 40% | Neutropenia common |
| Fludarabine plus cyclophosphamide66 | ORR stage IIB-III: 55% | Appears higher RR to fludarabine-alone; lymphopenia and prolonged myelosuppression in some patients; stem cell collection yields are lower |
| Gemcitabine63 | ORR stage IIB-III: 70% | Neutropenia; recent evidence that toxicities (rash, infection) may be higher in patients with CTCL (see “Systemic chemotherapy”) |
| 2-Chlorodeoxyadensine68 | ORR stage IIA-IV: 28% | Median duration or response of 4.5 months; bone marrow suppression and infections in 62% |
CR indicates complete response; CRR, complete response rate; EPOCH, etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone; ORR, overall response rate; PR, partial response; PUVA, ultraviolet A light with oral methoxypsoralen; and DFS, disease-free survival.
See “Systemic chemotherapy” for more details and other trial results.