Amitay-Laish I, Reiter O, Prag-Naveh H, Kershenovich R, Hodak E. Retinoic acid receptor agonist as monotherapy for early-stage mycosis fungoides: does it work?
J DERMATOL TREAT 2018;
30:258-263. [PMID:
29889596 DOI:
10.1080/09546634.2018.1487525]
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Abstract
BACKGROUND
Retinoids exert their biologic effects by binding to intracellular retinoic-acid receptors (RARs) and/or retinoid X receptors (RXRs). Early-stage mycosis fungoides (MF) has been effectively treated with bexarotene, an RXR-agonist, with overall response (OR) rates 54-67% and complete response (CR) rates 7-27%. Data on RAR-agonist monotherapy are limited.
OBJECTIVE
To analyze the effectiveness of RAR-agonist monotherapy for early-stage MF.
METHODS
Data on patients with early-stage MF treated with acitretin/isotretinoin monotherapy at a tertiary cutaneous lymphoma clinic in 2010-2017 were collected retrospectively from the medical files.
RESULTS
Thirty-five patients (26 males) of median age 50 years (range 8-83) with early-stage MF (IA 9, IB 26) underwent 37 treatment events: 25 acitretin and 12 isotretinoin at a median dosages of 0.3 mg/kg (range 0.2-0.9) and 0.2 mg/kg (range 0.1-0.7), respectively. Median time to maximal response was 6 months for both (range 1-10 for acitretin, 3-16 for isotretinoin); median treatment duration was 10 months (range 3-46) for acitretin, and 9 months (range 3-55) for isotretinoin. OR was 64% for acitretin and 80% for isotretinoin, and CR, 4% and 8%, respectively. Side-effect profiles were as previously reported for retinoids.
CONCLUSIONS
Early-stage MF patients may benefit from low dose RAR-agonist monotherapy, although the CR rate is low.
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