Mogamulizumab in the treatment of cutaneous T cell lymphoma

Introduction: Cutaneous T cell lymphomas are a heterogeneous group of malignancies characterized by the accumulation of malignantly transformed skin homing T cells. Mycosis fungoides, a typically indolent form of cutaneous T cell lymphoma characterized by patches, plaques, and tumors, and Sézary syndrome, a leukemic variant, make up the majority of cutaneous T cell lymphomas, and prognosis in advanced-stage disease remains poor. The defucosylated monoclonal antibody, mogamulizumab, targets the CC chemokine receptor 4 on malignant cells of cutaneous T cell lymphoma and offers a novel approach to treating advanced-stage disease. Areas covered: Mogamulizumab has shown efficacy in phase I/II clinical trials in patients with cutaneous T cell lymphoma, with overall response rates between 35–36.8%. Currently, a phase III trial is underway comparing mogamulizumab to vorinostat in the treatment of cutaneous T cell lymphoma. Expert opinion: Mogamulizumab has already been approved in Japan for the treatment of relapsed/refractory adult T cell leukemia/lymphoma. Clinical trials, currently in progress, are investigating the efficacy of mogamulizumab for advanced and metastatic solid tumors. Depletion of regulatory T cells, and the resulting boost in anti-tumor immunity caused by mogamulizumab, have great potential in the treatment of a wide range of malignancies, including cutaneous T cell lymphomas.