In what is being seen as a huge leap in cancer research, researchers at the Perelman School of Medicine at the University of Pennsylvania, have shown a topical gel might eliminate early stage malignant T cells and help reduce the lesions. Results of a phase-one trial show that the topical resiquimod gel, helps against both treated and untreated tumor lesions of early stage cutaneous T cell lymphoma (CTCL) – a rare type of non-Hodgkin lymphoma that affects the skin. The researchers are confident the gel might also completely remove cancerous cells from the lesions.
Before this study, there was no cure for CTCL aside from a bone marrow transplant. The results are giving renewed hope to patients who have not responded to topical chemotherapy, phototherapy and even systemic treatment with interferon alpha and oral bexarotene.
The full details of the study are published online this month in the journal Blood.
In the clinical trial, twelve patients who had already been subjected to an average of six treatments for early stage CTCL were treated with varying doses of topical resiquimod gel. Patients applied specified doses (0.03 percent of 0.06 percent) to select skin lesions for 16 weeks.
The patients using the 0.06 percent dose showed a full regression of all malignant cells after only eight weeks.
DNA from biopsies of the same treated lesion were analyzed before treatment and eight weeks after treatment to identify the number of malignant T cells. The percentage of malignant T cells improved significantly in 75% of tested participants. The percentage of malignant T cells was reduced significantly in nine of 10 participants, with three people showed complete eradication of the malignant cells.
Unlike other treatments, resiquimod improved treated as well as untreated lesions, resulting in more than 50 percent improvement for more than 90 percent of patients. Two participants, one of whom did not get any response to his CTCL lesions for more than 15 years of treatment, saw complete regression of the symptoms.
The results of the trial suggest that resiquimod is safely and effectively absorbed into the skin, and in addition to diminishing treated lesions, it also boosts the immune response, leading to healing of even untreated lesions.
According to first author and principal investigator, Alain Rook, this is the first topical therapy that can clear untreated lesions and lead to complete remission in some patients.
Building upon previous research, the study suggests resiquimod could be combined with other treatments to get relief from advanced CTCL. Researchers said more studies will need to be conducted, with a larger sample size, to determine the best approach and application for these patients.
Image: Using resiquimod on some CTCL legions has a systemic effect, which can be seen in significantly diminished legions that did not directly receive treatment.
CREDIT: Penn Medicine