Vorinostat In Combination With Other Agents For Therapy Of Cutaneous T-Cell Lymphomas: A Case Series

Background: Mycosis fungoides (MF) and Sezary Syndrome (SS) are types of cutaneous T-cell lymphoma (CTCL), a non-Hodgkin's lymphoma that mainly affects the skin but can progress to involve lymph nodes, blood, and visceral organs. Cure is rarely achieved in patients with advanced (≥Stage IIB) CTCL and patients progress after becoming intolerant of, or refractory to multiple treatment modalities. Treatment decisions for advanced CTCL are based on small prospective studies, retrospective observations, small case-series, and physician preference. Vorinostat (suberoylanilide hydroxamic acid, SAHA), the first histone deacetylase (HDAC) inhibitor, was approved by the FDA in October 2006 for CTCL patients with progressive, persistent, or recurrent disease on or following two systemic therapies based on the results of a Phase IIB trial which demonstrated an objective response in 30% of patients with ≥Stage IIB disease. It has been recently incorporated into the NCCN Clinical Practice Guidelines in Oncology™ for NHL. However, there are no reports available on use of vorinostat in combination regimens in CTCL. Here we present a case series of patients with advanced CTCL treated with vorinostat in combination with other therapies.