Journal Article

JAK Inhibitors in Cutaneous T-Cell Lymphoma: Friend or Foe? A Systematic Review of the Published Literature

Sadeghi, Sara, Kalantari, Yasamin, Fazeli, Patrick, Assaf, Chalid, Vahabi, Seyed Mohammad, Etesami, Ifa, Esmaeili, Farzad, Bahramian, Saeed, Hajizadeh, Nima, Danaei, Bardia

2024

Overview

Cutaneous T-cell lymphomas (CTCLs) are a group of lymphoid neoplasms with high relapse rates and no curative treatment other than allogeneic stem cell transplantation (allo-SCT). CTCL is significantly influenced by disruption of JAK/STAT signaling. Therefore, Janus kinase (JAK) inhibitors may be promising for CTCL treatment. This study is a systematic review aiming to investigate the role of JAK inhibitors in the treatment of CTCL, including their efficacy and safety. Out of 438 initially searched articles, we present 13 eligible ones. The overall response rate (ORR) in the treatment with JAK inhibitors in clinical trials was 11–35%, although different subtypes of CTCL showed different ORRs. Mycosis fungoides showed an ORR of 14–45%, while subcutaneous-panniculitis-like T-cell lymphoma (SPTCL) displayed an ORR ranging from 75% to 100%. Five cases were reported having a relapse/incident of CTCL after using JAK inhibitors; of these, three cases were de novo CTCLs in patients under treatment with a JAK inhibitor due to refractory arthritis, and two cases were relapsed disease after graft-versus-host disease treatment following allo-SCT. In conclusion, using JAK inhibitors for CTCL treatment seems promising with acceptable side effects, especially in patients with SPTCL. Some biomarkers, like pS6, showed an association with better responses. Caution should be taken when treating patients with an underlying autoimmune disease and prior immunosuppression.

• Publisher: MDPI AG,MDPI
• Subject: Adalimumab / Allografts / Anemia / Antimitotic agents / Antineoplastic agents / Autoimmune diseases / Binding sites / Case reports / Clinical trials / Development and progression / Disease / Drug dosages / Drug therapy / Enzyme inhibitors / Fungal infections / Graft-versus-host reaction / Immunosuppression / Immunosuppressive agents / Immunotherapy / Janus kinase / Kinases / Lymphocytes T / Lymphoma / Medical prognosis / Medical research / Medicine, Experimental / Mutation / Mycosis / Mycosis fungoides / Neutropenia / Non-Hodgkin's lymphomas / Patients / Proteins / Skin / Skin cancer / Stem cell transplantation / Stem cells / Systematic Review / T cells / T-cell lymphoma / Tofacitinib / Transplantation