Vorinostat in Combination Therapy of Sézary Syndrome with Extracorporeal Photopheresis

Abstract

Vorinostat, the first in its class of orally administered histone deacetylase inhibitors, was recently FDA-approved for therapy of skin manifestations of cutaneous T cell lymphoma. Vorinostat monotherapy demonstrated activity in patients with CTCL in clinical trials with an overall response rate of 30%. The combination of vorinostat with other agents or treatment modalities has not been formally evaluated. We hypothesized that the use of vorinostat in combination with extracorporeal photopheresis might be of benefit, theoretically through further induction of cell cycle arrest and apoptosis of malignant T lymphocytes. We present a case report of a patient with refractory Sezary syndrome who responded well to this combination without significant or unexpected side effects. Dr. Larisa Geskin, MD, FAAD is an Assistant Professor of Dermatology at the Department of Dermatology, University of Pittsburgh School of Medicine. Dr. Geskin serves as the Director of the Dermatological Branch of University of Pittsburgh Cancer Institute Multidisciplinary Melanoma Center, the Cutaneous Oncology and Photopheresis Center at the University of Pittsburgh Medical Center. She also is Director of the Dermatology Residency Program at the University of Pittsburgh Medical School. Dr. Larisa Geskin’s broad research interests include exploring etiology of CTCL and abnormalities found in malignant cells of patients with CTCL. Her main focus is to investigate and define immunologic abnormalities found in patients with CTCL and to develop novel immunologic therapies for CTCL. She conducts numerous clinical trials investigating new treatments for CTCL, including a dendritic cell vaccine trial for patients with Sezary syndrome.