Oral Targretin was approved as a second line treatment because CTCL is typically initially treated with a topical or non-systemic agent. In general, most of these patients eventually fail to adequately control their disease and move onto an additional treatment.
It seemed that oral Targretin had a clear lead among the second line, systemic treatments which include chemotherapeutic agents which have much harsher side effects. Other agents such as interferon also had major side effects and many patients wanted to stay away from such treatments for as long as possible.
What I found most interesting was the fact that even though the patient moved to oral Targretin after being treated with topical Targretin, she still responded, and did so quite satisfactorily.
Of course, as you know, LGND has submitted an NDA for topical Targretin, and it too has been granted priority review, so we should have an answer on that one in less than 5 months. The topical approaches are less likely to have side effects, but they do seem to produce a response of limited duration.
If approved, LGND will have 3 treatment options for CTCL patients. Initially they will be treated with topical Targretin, followed by oral Targretin, followed by intravenous ONTAK.
It is likely that such choices will also have applications for plaque psoriasis. |
