Hypericin photodynamic therapy (PDT) is effective for early-stage mycosis fungoides-cutaneous T-cell lymphoma (MF/CTCL), according to a study published online July 20 in JAMA Dermatology .

Ellen J. Kim, M.D., from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues examined the efficacy and safety of topical synthetic hypericin ointment activated with visible light as a nonmutagenic PDT in early-stage MF/CTCL. One hundred sixty-nine patients were randomly assigned 2:1 to receive hypericin or placebo for three index lesions twice weekly for six weeks in cycle 1. All patients received the active drug to index lesions for six weeks in cycle 2. In cycle 3 (optional), patients received the active drug to index and additional lesions.

The researchers found that hypericin PDT was more effective than placebo after six weeks of treatment (cycle 1 index lesion response rate [ILRR], 16 versus 4 percent). In patients who received two cycles of hypericin PDT, the ILRR increased to 40 percent and then to 49 percent after three cycles. Both patch- and plaque-type lesions showed significant clinical responses, and these responses were similar irrespective of age, sex, race, stage IA versus IB, time since diagnosis, and number of prior therapies. Mild local skin and application-site reactions were the most common treatment-related adverse events.

"Given that MF/CTCL requires long-term disease management and that many patients using current skin-directed therapies experience short- and/or long-term adverse effects, limited access, and waning efficacy, these findings are an important contribution to MF/CTCL patient care," the authors write.

Several authors disclosed financial ties to biopharmaceutical companies, including Soligenix, which funded the study.

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