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Levy Yurkovski I, Andreazzoli F, Ben-Arye E, Attias S, Tadmor T. Integrative Approaches in the Treatment of Patients Affected by Lymphoma. Curr Oncol Rep 2023; 25:1523-1534. [PMID: 38060095 DOI: 10.1007/s11912-023-01476-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE OF REVIEW Lymphoma is the most frequent hematological malignancy with wide disease spectrum of watchful waiting period, active treatment, survivorship, and palliative care. All these steps impose unmet needs in terms of prevention, symptom alleviation, or prognosis. Complementary and integrative medicine (CIM) is widely used by patients with lymphoma to cope with such issues. Here, we describe the different CIM modalities that may be effective and safe for the management of patients with lymphoma. RECENT FINDINGS Low inflammatory diet and ginseng seem effective for lymphoma prevention. Pain and neuropathy may be improved using acupuncture, touch therapy and specific dietary supplements. Nausea/vomiting, fatigue, and insomnia may be relieved by acupuncture, mind-body, touch therapy, and certain dietary supplements. Vitamin D, curcumin, and some traditional medicine herbs may positively impact lymphoma prognosis. Finally, safety issues should be considered especially for the concomitant use of dietary supplements and lymphoma-directed therapies. CIM may be beneficial along the continuum of lymphoma management although safety concerns should be considered when used concomitantly with conventional therapy.
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Affiliation(s)
- Ilana Levy Yurkovski
- Hematology Unit, Bnai Zion Medical Center, Golomb 47, 33394, Haifa, Israel.
- Complementary Medicine Service, Bnai Zion Medical Center, Haifa, Israel.
- Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel.
| | | | - Eran Ben-Arye
- Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
- Integrative Oncology Program, The Oncology Service, Lin, Carmel & Zebulun Medical Centers, Clalit Health Services, Western Galilee District, Haifa, Israel
| | - Samuel Attias
- Complementary Medicine Service, Bnai Zion Medical Center, Haifa, Israel
| | - Tamar Tadmor
- Hematology Unit, Bnai Zion Medical Center, Golomb 47, 33394, Haifa, Israel
- Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
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Cannabis use among patients with cutaneous lymphoma: A cross-sectional survey. Complement Ther Med 2022; 67:102830. [PMID: 35395396 DOI: 10.1016/j.ctim.2022.102830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/15/2022] [Accepted: 04/04/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To evaluate patterns of cannabis use in patients with cutaneous lymphoma (CL), as well as the association between cannabis use and itch specifically. DESIGN Cross-sectional survey created in partnership with the Cutaneous Lymphoma Foundation (CLF). SETTING The online survey was distributed electronically via email to the CLF listserv and links posted to social media over a 2-week period. Main Outcome Measures Respondents were classified as current cannabis users, prior users, and never users. A visual analog scale (VAS) was used to assess itching severity, improvement of itch, and interest in learning about cannabis. RESULTS A total of 119 patient responses (61% female, mean age 59y) were included in analysis. The majority had mycosis fungoides or Sézary syndrome (74%; 88/119) and early stage (IA-IIA) disease (56%; 48/86). Mean VAS itch score was 3.2 + 2.8 for the cohort. Over half (55%; 60/110) reported ever having used cannabis, with 22% (24/110) endorsing current cannabis use. Common methods of cannabis use were smoking (54%) and vaporizing (46%). 25% (6/24) of current users reported using cannabis specifically to treat itch; these respondents noted that cannabis resulted in moderate improvement of itching (mean 6.6/10). There was strong interest in learning more about cannabis and cancer, and most desired this information from their CL doctor/nurse. CONCLUSIONS Cannabis use is common among patients with CL, and patients report improvement of itching as a result of using cannabis. Further studies are needed to elucidate the risks and benefits of cannabis use in this patient population.
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Wind SS, Jansen MAA, Rijsbergen M, van Esdonk MJ, Ziagkos D, Cheng WC, Niemeyer-van der Kolk T, Korsten J, Gruszka A, Schmitz-Rohmer D, Bonnel D, Legouffe R, Barré F, Bekkenk MW, de Haas ERM, Quint KD, Rolli M, Streefkerk HJ, Burggraaf J, Vermeer MH, Rissmann R. Topical Bimiralisib Shows Meaningful Cutaneous Drug Levels in Healthy Volunteers and Mycosis Fungoides Patients but No Clinical Activity in a First-in-Human, Randomized Controlled Trial. Cancers (Basel) 2022; 14:cancers14061510. [PMID: 35326659 PMCID: PMC8946662 DOI: 10.3390/cancers14061510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/04/2022] Open
Abstract
Mycosis fungoides (MF) is a subtype of CTCL with a low incidence and high medical need for novel treatments. The objective of this randomized, placebo-controlled, double-blinded, first-in-human study was to evaluate safety, efficacy, cutaneous and systemic pharmacokinetics (PK) of topical bimiralisib in healthy volunteers (HVs) and MF patients. In this trial, a total of 6 HVs and 19 early-stage MF patients were treated with 2.0% bimiralisib gel and/or placebo. Drug efficacy was assessed by the Composite Assessment of Index Lesion Severity (CAILS) score, supported by objective measuring methods to quantify lesion severity. PK blood samples were collected frequently and cutaneous PK was investigated in skin punch biopsies on the last day of treatment. Local distribution of bimiralisib in HVs showed a mean exposure of 2.54 µg/g in the epidermis. A systemic concentration was observed after application of a target dose of 2 mg/cm2 on 400 cm2, with a mean Cavg of 0.96 ng/mL. Systemic exposure of bimiralisib was reached in all treated MF patients, and normalized plasma concentrations showed a 144% increased exposure compared to HVs, with an observed mean Cavg of 4.49 ng/mL and a mean cutaneous concentration of 5.3 µg/g. No difference in CAILS or objective lesion severity quantification upon 42 days of once-daily treatment was observed in the MF patient group. In general, the treatment was well tolerated in terms of local reactions as well as systemic adverse events. In conclusion, we showed that topical bimiralisib treatment leads to (i) meaningful cutaneous drug levels and (ii) well-tolerated systemic drug exposure in MF patients and (iii) a lack of clinical efficacy, in need of further exploration due to numerous unknown factors, before depreciation of topical bimiralisib as a novel therapeutic drug for CTCLs.
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Affiliation(s)
- Selinde S. Wind
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
- Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.D.Q.); (M.H.V.)
| | - Manon A. A. Jansen
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - Melanie Rijsbergen
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - Michiel J. van Esdonk
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - Dimitrios Ziagkos
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - Wing C. Cheng
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - Tessa Niemeyer-van der Kolk
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - John Korsten
- Charles River Laboratories Den Bosch B.V., 5231 DD Den Bosch, The Netherlands; (J.K.); (A.G.)
| | - Agnieszka Gruszka
- Charles River Laboratories Den Bosch B.V., 5231 DD Den Bosch, The Netherlands; (J.K.); (A.G.)
| | | | - David Bonnel
- MS Imaging Department, ImaBiotech, 59120 Lille, France; (D.B.); (R.L.); (F.B.)
| | - Raphael Legouffe
- MS Imaging Department, ImaBiotech, 59120 Lille, France; (D.B.); (R.L.); (F.B.)
| | - Florian Barré
- MS Imaging Department, ImaBiotech, 59120 Lille, France; (D.B.); (R.L.); (F.B.)
| | - Marcel W. Bekkenk
- Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands;
| | | | - Koen D. Quint
- Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.D.Q.); (M.H.V.)
| | - Melanie Rolli
- PIQUR Therapeutics AG, 4057 Basel, Switzerland; (D.S.-R.); (M.R.); (H.J.S.)
| | | | - Jacobus Burggraaf
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
- Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.D.Q.); (M.H.V.)
- Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands
| | - Maarten H. Vermeer
- Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.D.Q.); (M.H.V.)
| | - Robert Rissmann
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
- Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.D.Q.); (M.H.V.)
- Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands
- Correspondence:
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