Monoclonal antibodies against cutaneous T-cell lymphomas

Cutaneous T-cell lymphomas (CTCLs) comprise of a group of rare and heterogeneous skin lymphoproliferative disorders derived from skin resident T cells. Treatment of CTCLs is based on skin-directed approaches and/or systemic therapies. Advanced CTCLs are difficult to treat with the currently available treatments as they generally fail to obtain prolonged clinical remission. Recent studies concerning the pathogenetic mechanisms that are operative in CTCL have provided additional potential therapeutic targets for the treatment of these disorders. In particular, development of novel monoclonal antibodies against presumptive pathogenic molecules has resulted in targeted approaches to the clinical management of this group of lymphoproliferative disorders. Areas covered: The following article examines the current and emerging monoclonal antibody-based therapies for CTCL, with a particular focus on mycosis fungoides, primary cutaneous anaplastic large cell CD30+ lymphoma and Sezary syndrome. Expert opinion: These novel monoclonal antibodies may represent an innovative approach for targeted treatment of CTCL given their increased clinical efficacy and the acceptable toxicity profiles of most antibodies. In particular, anti-CD52, anti-CD30 and anti-CCR4 monoclonal antibodies represent the most promising agents with single agent activity, although the combination of these targeted monoclonal antibodies with other active agents deserves attention.