Amitay-Laish Iris, Reiter Ofer, Prag-Naveh Hadas, Kershenovich Ruben, Hodak Emmilia
a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel.
b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
J Dermatolog Treat. 2019 May;30(3):258-263. doi: 10.1080/09546634.2018.1487525. Epub 2018 Jul 30.
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.
To analyze the effectiveness of RAR-agonist monotherapy for early-stage MF.
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.
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.
Early-stage MF patients may benefit from low dose RAR-agonist monotherapy, although the CR rate is low.
维甲酸类药物通过与细胞内视黄酸受体（RARs）和/或维甲酸X受体（RXRs）结合发挥其生物学效应。早期蕈样肉芽肿（MF）已通过RXR激动剂贝沙罗汀得到有效治疗，总体缓解（OR）率为54 - 67%，完全缓解（CR）率为7 - 27%。关于RAR激动剂单药治疗的数据有限。
分析RAR激动剂单药治疗早期MF的有效性。
回顾性收集2010 - 2017年在一家三级皮肤淋巴瘤诊所接受阿维A/异维A酸单药治疗的早期MF患者的医疗档案数据。
35例（26例男性）中位年龄50岁（范围8 - 83岁）的早期MF患者（IA期9例，IB期26例）接受了37次治疗：25次阿维A治疗和12次异维A酸治疗，中位剂量分别为0.3mg/kg（范围0.2 - 0.9）和0.2mg/kg（范围0.1 - 0.7）。两者达到最大反应的中位时间均为6个月（阿维A为1 - 10个月，异维A酸为3 - 16个月）；阿维A的中位治疗持续时间为10个月（范围3 - 46个月），异维A酸为9个月（范围3 - 55个月）。阿维A的OR为64%，异维A酸为80%，CR分别为4%和8%。副作用情况如先前报道的维甲酸类药物。
早期MF患者可能从低剂量RAR激动剂单药治疗中获益，尽管CR率较低。
