Clinical Efficacy of Romidepsin in Tumor Stage and Folliculotropic Mycosis Fungoides

Patients with cutaneous T-cell lymphoma (CTCL) who have cutaneous tumors or folliculotropic disease involvement typically have a poor prognosis. Analysis of the pivotal phase II trial of romidepsin for relapsed or refractory CTCL showed that single-agent romidepsin induced a clinical response or stable disease in most patients with cutaneous tumors and/or folliculotropic disease involvement, supporting its use in these patient populations. Background Tumor stage and folliculotropic mycosis fungoides are uncommon subtypes of cutaneous T-cell lymphoma (CTCL) with an aggressive disease course. Romidepsin is a histone deacetylase inhibitor approved by the US Food and Drug Administration for patients with CTCL who have received ≥ 1 previous systemic therapy. In the present study, we examined the efficacy and safety of romidepsin in patients from the pivotal, single-arm, open-label, phase II study of relapsed or refractory CTCL with cutaneous tumors and/or folliculotropic disease involvement. Materials and Methods Patients with CTCL who had received ≥ 1 previous systemic therapy received romidepsin at 14 mg/m² on days 1, 8, and 15 of 28-day cycles. Responses were determined by a composite endpoint (assessments of the skin, blood, and lymph nodes). Patients with cutaneous tumors and/or folliculotropic disease involvement were identified by review of diagnosis and histology reports. Results The objective response rate to romidepsin was 45% in patients with cutaneous tumors (n = 20) and 60% in patients with folliculotropic disease involvement (n = 10). Conclusion Romidepsin is active in subtypes of CTCL with less favorable outcomes, such as tumor stage and folliculotropic mycosis fungoides.