PHILADELPHIA - Individuals with parapsoriasis, a red, scaly rash located in the “bathing suit” area, could be at risk for developing a potentially deadly cancer. Researchers at Fox Chase Cancer Center are conducting an innovative clinical trial using bexarotene (Targretin®), a form of vitamin A in a topical gel, to treat parapsoriasis and prevent the disease from progressing into cancer.
“What’s unique about this trial is that we are treating what is considered a precursor to cancer,” says Stuart Lessin, MD, director of the Dermatology Oncology Program at Fox Chase Cancer Center. A precursor acts as a warning sign alerting that the onset of cancer is imminent.
Parapsoriasis is a skin condition considered a precursor to cutaneous T-cell lymphoma, (CTCL) which is a potentially deadly form of cancer that manifests in the skin and targets the body’s white blood cells (lymphocytes), impairing the patient’s immune system. Despite its name, parapsoriasis differs from psoriasis in its appearance and location on the body. The skin condition starts as red, scaly rash that appears on the trunk of the body, instead of on the extremities.
“Parapsoriasis has a similar name to psoriasis, but it’s a very different disease,” says Lessin. “Parapsoriasis has the potential to progress to CTCL and differentiation between parapsoriasis and early stage CTCL can be difficult and often requires evaluation by an experienced specialist,” says Lessin.
Patients can live with the complications of CTCL long after the initial diagnosis and according to the Mycosis Fungoides Foundation, approximately 16,000 people in the United States are affected with the disease annually. CTCL slowly progresses from scaling skin patches to larger areas of thickened plaques and then to tumor nodules. In the late stages, the cancer grows to involve lymph nodes, blood and internal organs and most patients die from infections due to breakdown of the skin and a crippled immune system.
The FDA has approved Targretin® for the treatment of CTCL, but Lessin and his colleagues are using the gel as a prevention tool. “If we can treat patients who are diagnosed with parapsoriasis, we can potentially stop the cancer before it has a chance to start or progress,” says Lessin.
Bexarotene (Targretin®) is a unique type of retinoid, a synthetic form of vitamin A that binds to specific retinoid receptors and regulates cell function. The drug inhibits cancer growth and induces apoptosis, or programmed cell death.
Patients who are newly diagnosed with parapsoriasis or who have skin lesions suggestive of, but not diagnostic of CTCL, maybe eligible to participate in this clinical trial, which is only available at Fox Chase Cancer Center. In the trial, the topical gel is initially applied to the skin lesions everyday for two weeks, than twice a day for up to 16 weeks. Tissue from the skin lesions is taken or biopsied before and after treatment to determine response to the gel.
“We’re hoping that patients suffering from parapsoriasis will respond to the Targretin® therapy, whereby clearing up the uncomfortable condition, and preventing further progression of the disease,” Lessin said.
The trial is sponsored by Ligand Pharmaceuticals Incorporated makers of Targretin®.
Fox Chase Cancer Center, one of the nation's first comprehensive cancer centers designated by the National Cancer Institute in 1974, conducts basic and clinical research; programs of prevention, detection and treatment of cancer; and community outreach. For more information about Fox Chase activities, visit the Center's web site at http://www.fccc.edu or call 1-888-FOX CHASE.