Herein we provide an overview of all available data on the use of chlormethine (CL) gel in adults with mycosis fungoides (MF).

CL gel, which primarily targets malignant T cells, is the first topical chemotherapy that was specifically developed for treatment of MF, with no evidence of systemic absorption.

CL gel is highly effective, with better response rates observed with the gel formulation compared with ointment in both clinical trial and real-world settings.

In real-world clinical practice, CL gel is often used at variable or lower treatment frequencies compared to product label indication (once daily), and combination therapy with other agents is common.

CL gel has a manageable safety profile, with most adverse events being mild and skin related—contact dermatitis being the most common.