Home: Publications: Forum Archives: MFF Forum, edition 2
New CTCL Research Presented at Annual Meeting of the SID
by
Stuart R. Lessin, M.D. Director of Dermatology, Fox Chase Cancer
Center, Philadelphia, PA
The 63rd Annual Meeting
of the Society for Investigative Dermatology (SID) took place in
Los Angeles, California from May 16-19, 2002. Investigators from
around the world submitted over 850 original abstracts. New findings
related to CTCL were well represented.
In an address to the Society,
Dr. Richard Edelson, Professor and Chairman of the Department of
Dermatology at Yale University, presented new findings pertaining
to the mechanisms underlying the therapeutic effects of photopheresis.
Experiments conducted by the Yale research team have shown that photopheresis
may be more effective if the re-infusion of treated blood cells is
delayed for a period of time. Clinical trials will be required to
determine how beneficial new photopheresis treatment regimens will
be.
Dr. Youn Kim, Professor
and Director of the Cutaneous Lymphoma Program at Stanford University,
provided a state-of-the-art lecture on CTCL prognostic factors and
therapies to the entire Society. She reported that the current staging
system, developed in 1978, still provides the best prognostic information;
that is, the extent of skin involvement at the time of diagnosis
still is the best indicator of how a patient will fare with his or
her disease. For advanced stages of CTCL, the International Society
is developing additional blood staging categories that more accurately
reflect the amount of blood involvement for Cutaneous Lymphoma. This
will aid in treatment decision-making and in evaluating treatment
results in clinical trials. Dr. Kim also announced that a new clinical
trial, testing a therapeutic vaccine that targets the T-cell receptor
on CTCL cells, would be starting this summer at Stanford University.
In other presentations,
the Stanford group reported the long-term outcome of 525 patients
with CTCL that were treated and followed at their institution for
up to 30 years. Patients with limited disease (less than 10% of body
surface area involvement or T1) had the same overall survival rate
as controls without CTCL. Patients who were older and had advanced
disease or extracutaneous disease at the time of diagnosis were at
the greatest risk of progression. The Stanford Group also reported
their long-term experience with topical nitrogen mustard treatment
by reviewing the results of 203 patients treated at Stanford. They
show that 93% of patients with T1 disease responded to treatment
(65% completely) by ten months, on average. For patients with greater
than 10% of the body surface area involved (T2), the response rate
was 72% (34% completely) by 19 months, on average. Approximately
83-85% from both groups were free from progression of disease at
ten years. Less than 10% of all treated patients experienced allergic
reactions to nitrogen mustard when treated with ointment-based, compared
to 6% with aqueous or water-based preparations.No
patients developed secondary skin cancers attributable to topical
nitrogen mustard.
Other groups reported on
newly characterized defects in immunity that may help our understanding
of the cause of CTCL, and in designing new immunotherapies. Also,
several groups reported on their work of identifying specific receptors
on CTCL cells that, when activated, results in cell death. These
receptors appear to interact with therapeutic agents, such as bexarotene
(Targretin®) and may explain how retinoids may be involved in
enhancing CTCL cell death.
Judith Shea and Dr. Madeleine Duvic at MFF exhibit
Patients and physician interacting at SID meeting
Drs. Robert Knobler and Franz Trautinger from the
Department of Dermatology, University of Vienna Medical School
Division of Special and Environmental Dermatology
Judith Shea discussing poster with Kathy MacDonald,
Steve Froberg, Charlotte and Maurice Hamm
