Oncology Frontier:  What treatment should be used for advanced refractory CTCL?

　　《肿瘤瞭望》：晚期难治性CTCL怎么治疗？

　　Dr Prince: It is fair to say that for upfront advanced tumor disease， we would still consider interferon， bexarotene and low-dose methotrexate depending on the aggressiveness. But then if it is not effective or if we choose to go straight to a biological agent， then HDAC inhibitors have to be very high on the list. Pralatrexate has to be high on the list and monoclonal antibodies such as alemtuzumab or fusion toxins such as denileukin diftitox are very good options. Some of the new treatments with the anti-CCR4 antibody look very promising and certainly in patients with CD30-positive disease， the studies with brentuximab vedotin look very promising. I would predict that in the next few years， assuming that these new trials are positive and with the phase II data looking very promising， we will be seeing good response rates with the CD30-positive disease. What we don’t really have a good understanding of though is the duration of remissions in those patients.

　　Prince博士：根据肿瘤的侵袭性，晚期CTCL首先选择干扰素、贝沙罗汀和低剂量甲氨蝶呤治疗。如果该方案不奏效，则选用生物制剂治疗， HDAC抑制剂、普拉曲沙、单克隆抗体（如阿来组单抗，Alemtuzumab）或融合毒素（如地尼白介素）都是比较好的选择。抗CCR4抗体治疗效果令人期待。对于CD30阳性的患者，新型靶向抗体-药物偶联物brentuximab vedotin的研究数据良好。但是还不清楚这些新药治疗的缓解持续时间有多长。