ro-13-6298 and Lymphoma

Five patients with refractory advanced cutaneous T-cell lymphoma (CTCL) (Stage IIB, two; Stage III, one; Stage IVA, two) and one patient with a refractory Stage IB CTCL (two females, four males, median age 58 years) were treated with a new polyaromatic retinoid, arotinoid-ethylester (Ro 13-6298), which has a much higher antiproliferative activity than other known retinoids. There was an objective clinical response in three of six cases [complete remission (CR) = 1, partial remission (PR) = 2]. One patient is in CR since 102 weeks currently. Mean duration of PR was 43 weeks. Two patients were withdrawn from treatment after 4 weeks because of disease progression. Two patients, one of them in PR, had to be retired from further treatment due to toxic side effects. Main side effects were mucocutaneous dryness, skin atrophy, and skin vulnerability. Skin biopsies were performed on four patients 4 weeks after the start of treatment. The epidermis and the subepidermal grenz zone were found to be clear of mononuclear clear cell infiltration in three patients. Although the number of patients is small, the results obtained suggest that arotinoid-ethylester offers a promising approach to the treatment of CTCL.

Topics: Adult; Aged; Antineoplastic Agents; Benzoates; Female; Humans; Lymphoma; Male; Middle Aged; Prognosis; Retinoids; Skin Neoplasms

Mycosis fungoides is a neoplasia immunologically defined as a cutaneous T cell lymphoma. It is an uncommon, chronic, and usually fatal disease that runs a progressive multistaged course. The present study describes a case of mycosis fungoides, limited to the skin, which was successfully controlled with the arotinoid Ro 13-6298. Review of the role of retinoids in dermatology and oncology is presented with a special emphasis on the arotinoid.

Topics: Antineoplastic Agents; Benzoates; Drug Therapy, Combination; Etretinate; Female; Humans; Lymphoma; Middle Aged; Mycosis Fungoides; PUVA Therapy; Retinoids; Skin Neoplasms; T-Lymphocytes

Sixteen patients - 12 with cutaneous T cell lymphoma (CTCL), 1 with Sézary syndrome, 1 with actinic reticuloid, and 2 with parapsoriasis variegata - were treated with either a new, potent arotinoid alone or with combined etretinate (Tigason) and PUVA therapy (Re-PUVA). 92% of all patients showed a minor up to a distinct response of their skin lesions within 12.6 +/- 7.4 weeks. More than 50% of the skin lesions cleared in 67% of the patients. After discontinuation of the retinoid therapy, relapses occurred in all cases within 3-10 weeks. There was no difference between the therapeutic efficacy of arotinoid alone and the Re-PUVA regimen, but the latter was less toxic.

Topics: Antineoplastic Agents; Benzoates; Combined Modality Therapy; Humans; Isotretinoin; Lymphoma; PUVA Therapy; Retinoids; Skin Neoplasms; T-Lymphocytes; Tretinoin

Five patients with T-cell lymphoma of the skin (mycosis fungoides; Sézary syndrome) were given parenterally arotinoid ethyl ester (Ro 13-6298) at a daily dose of 0.5-4.0 micrograms/kg body weight, to a total dose of 20 mg over maximally 31 weeks. In three patients, among them one with tumourous mycosis fungoides, there was complete regression of the cutaneous lesions. In another patient the cutaneous changes, some of them with ulceration, regressed so that there were only residual infiltrates. In the case of the Sézary syndrome there was no response. Most important side-effects of treatment were cheilitis, moist and sticky skin, paronychia and dry mucosae. The most serious side-effect was pain in muscles, joints and bones. There were no significant changes in biochemical values during the treatment.

Topics: Adult; Aged; Alopecia; Benzoates; Female; Humans; Lymphoma; Male; Middle Aged; Mycosis Fungoides; Pain; Retinoids; Sezary Syndrome; Skin Neoplasms; T-Lymphocytes