Optimizing bexarotene therapy for cutaneous T-cell lymphoma

Bexarotene (Targretin® oral capsules) is the first RXR selective retinoid rexinoid, approved for all stages of cutaneous T-cell lymphoma (CTCL). Two phase II clinical trials were conducted in early and advanced patients with CTCL (Mycosis Fungoides (MF) and Sezary Syndrome (SS). The overall response rate RR was 45% at an optimal dose of 300 mg/m2/day. Higher response rates were seen in earlier patients (54%) and at higher doses 300 mg/m2/day. Hypertriglyceridemia was reported in 79% of the patients and therefore we always administer liipid lowering agents (LLA) to optimize the clinical response. Statins (inhibitors of HMG-CoA reductase) may modulate class II MHC expression and T-cell responses.