Response to hydralazine-valproate in a patient with mycosis fungoides

Area of Science:

• Oncology
• Epigenetics
• Dermatology

Background:

• Cutaneous T-cell lymphomas (CTCL) exhibit epigenetic alterations beyond histone acetylation, including aberrant DNA methylation.
• Histone deacetylase (HDAC) inhibitors have demonstrated significant therapeutic activity in CTCL.
• Combining HDAC inhibitors with DNA demethylating agents represents a promising therapeutic strategy for CTCL.

Observation:

• A patient diagnosed with mycosis fungoides, a type of CTCL, was treated with repositioned drugs.
• The treatment involved hydralazine, an HDAC inhibitor, and valproate, a DNA methylation inhibitor.

Findings:

• The mycosis fungoides patient exhibited a dramatic and positive response to the combination therapy.
• The combined inhibition of HDAC and DNA methylation pathways led to significant clinical improvement.

Implications:

• Repositioned drugs like hydralazine and valproate offer a viable therapeutic option for CTCL.
• Targeting both histone acetylation and DNA methylation may be a potent strategy for treating CTCL.
• This case highlights the potential of epigenetic-modulating drug combinations in managing refractory CTCL.