When cutaneous T-cell lymphoma does not respond to skin-directed therapy, doctors at NYU Langone may use whole-body medications to help kill cancer cells throughout the body.
Whole-body medications are also an option if the cancer is found to be growing quickly when first diagnosed. Sometimes, these medications may be used in combination with each other, with skin-directed therapies, or with another whole-body treatment called photopheresis, which may be recommended for advanced mycosis fungoides covering a large part of the body and for Sézary syndrome.
Types of Medication
Treatment with any whole-body medication for cutaneous T-cell lymphoma may last for many months, although the duration and frequency of therapy varies from person to person. Your doctor determines the appropriate course of treatment for you based on your specific needs.
Immunomodulators are medications made of naturally occurring proteins that help create an immune response against cancer, making it less likely that lymphoma cells survive and reproduce. NYU Langone doctors may use the immunomodulator interferon, which is given by injection under the skin, to manage cutaneous T-cell lymphoma.
Retinoids, which are medications made from vitamin A, may help damage cancer cells and slow their growth. Our doctors may prescribe the oral retinoid bexarotene to treat cutaneous T-cell lymphoma. Both women and men should discuss with their doctor the possibility of birth defects before taking bexarotene.
The enzyme inhibitor romidepsin targets and blocks enzymes found at particularly high levels in cancerous T-cell lymphocytes, helping to slow or stop cancer growth. The medication is given through a vein with intravenous (IV) infusion. Our doctors may also give vorinostat, another enzyme inhibitor, which is taken by mouth.
Methotrexate is a form of chemotherapy given to people with cutaneous T-cell lymphoma. It prevents lymphoma cells from using folic acid, a B vitamin, to create more cancer cells. Methotrexate is either taken by mouth or given through an injection.
A monoclonal antibody medication is made with antibodies, which are immune proteins that recognize substances as foreign and help to remove them from the body. These medications can attach to proteins found on the surface of cancerous T-cells, interfering with their ability to function. Because these medications target cancer cells and not healthy tissues, they may cause fewer side effects than chemotherapy.
Alemtuzumab and brentuximab vedotin are two monoclonal antibodies used to treat people with cutaneous T-cell lymphoma. Both of these medications are given through an IV infusion.
Managing Side Effects
Whole-body medications may cause several side effects, including fatigue; low blood cell levels; elevated blood levels of triglycerides, a form of fat found in the blood; nausea; and diarrhea. Doctors at NYU Langone may adjust the dose of your medication and use additional medications to address any side effects you are experiencing. Palliative care specialists at NYU Langone can offer support services to help you manage the side effects of these therapies.
Our doctors are studying the use of several new targeted medications, which home in on cancer cells and spare healthy tissue, in the treatment of cutaneous T-cell lymphoma, as well as combinations of chemotherapy and radiation therapy. You and your doctor can discuss whether you are a candidate for one of NYU Langone’s clinical trials and if so how to enroll.
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