Cutaneous T-cell Lymphoma Clinical Trial
Official title:
A Pilot Study of a Novel Multimodality Immuno-Chemotherapy Platform for Patients With Advanced Cutaneous T Cell Lymphoma
This study evaluates the safety and tolerability of the addition of immunostimulatory therapy consisting of focal radiation with or without the Toll-like receptor (TLR) agonist Poly ICLC in patients with cutaneous T-cell lymphoma (CTCL) receiving concurrent therapy with the histone deacetylase inhibitor (HDACI) Romidepsin.
Histone deacetylase inhibitors in epigenetic therapy are one of the most active anti-tumor
agents in patients with relapsed and refractory CTCL despite their suppressive effects on T
cell function, yet the overall response rate and response duration with these agents remains
suboptimal. Immune stimulatory agents may be the ideal therapy to combine with HDACI. To
date, no one has evaluated whether the abscopal effect of radiation with and without the
additional immune stimulation of a TLR-3 agonist can augmented the efficacy of anti-tumor
directed epigenetic therapy in mycosis fungoides (MF) patients. The investigators hypothesize
that a combined modality immuno-chemotherapy may be highly effective in patients with
advanced MF.
This is a phase I study. It involves two arms of patients (A and B) who will be treated
following a standard 3+ 3 design. Patients on Arm A are the ones who are initiating HDACI
therapy, and patients on Arm B are the ones with stable disease or partial response with
HDACI treatment. Both groups receive HDACI, plus at level 1, focal lesional radiation; at
level 2, radiation in combination with Poly ICLC. Each arm will be evaluated and escalated
independently.
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