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Current Epigenetic Therapy for T-Cell Lymphoma

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Book cover T-Cell Lymphomas

Part of the book series: Contemporary Hematology ((CH))

Abstract

Cutaneous T-cell lymphoma (CTCL) is challenging to treat. Patients with advanced disease typically only enjoy brief responses to conventional chemotherapeutics, and are at particularly high risk of infectious complications during the treatment with chemotherapy. Combination and intensification of conventional chemotherapeutics fails to cure the vast majority of patients with CTCL or other forms of peripheral T-cell lymphoma (PTCL). In this context, biological agents, and in particular the histone deacetylase inhibitors (HDACis), present an attractive alternative because they lack many of the side effects of conventional chemotherapy and appear to overcome chemotherapy resistance.

The HDACis target not only the epigenome but also numerous nucleic and cytoplasmic non-histone proteins and are powerful and selective inducers of cancer cell apoptosis and modifiers of the tumour microenvironment. To date, the best data for their use comes from trials in the lymphoid malignancies and CTCL is the only condition for which HDACis are currently registered. The FDA has approved romidepsin and vorinostat for use in relapsed/refractory CTCL and these agents provide patients with a new opportunity for durable clinical response. Similarly, romidepsin has potent activity in nodal PTCLs, with emerging data supporting a future role in clinical practice, either alone or in combination with conventional therapies.

Here we discuss the concept of epigenetic modifying agents, briefly review the putative targets for the HDACis and discuss key clinical trials supporting their use in T-cell lymphoma.

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Authors and Affiliations

  1. Division of Cancer Medicine, Peter MacCallum Cancer Centre, Locked Bag1, Melbourne, 8006, VIC, Australia

    Michael Dickinson M.B.B.S. (Hons), F.R.A.C.P., F.R.C.P.A. & Chan Cheah M.B.B.S. (Hons)

  2. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Melbourne, 3010, VIC, Australia

    Michael Dickinson M.B.B.S. (Hons), F.R.A.C.P., F.R.C.P.A.

  3. Sir Peter MacCallum Department of Oncology, Division of Cancer Medicine, Peter MacCallum Cancer Centre, Parkville, Melbourne, VIC, Australia

    H. Miles Prince M.B.B.S. (Hons), M.D., M.R.A.C.M.A., F.R.A.C.P., F.R.C.P.A.

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Correspondence to Michael Dickinson M.B.B.S. (Hons), F.R.A.C.P., F.R.C.P.A. .

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  1. Yale University School of Medicine, Dept. of Medical Oncology/Hematology, Cedar Street 333, New Haven, 06520, Connecticut, USA

    Francine Foss

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Dickinson, M., Cheah, C., Prince, H.M. (2013). Current Epigenetic Therapy for T-Cell Lymphoma. In: Foss, F. (eds) T-Cell Lymphomas. Contemporary Hematology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-170-7_16

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