On this page we will be discussing HDAC inhibitors and the main types that are currently being used in the treatment of some lymphomas.
What are HDAC inhibitors?
Histone deacetylase (HDAC) are proteins that help cells to grow and divide. Some cancers can alter the body’s immune system so that they are able to continue to grow in an uncontrolled way and do not die as they should. They in turn allow cancer cells to grow.
HDAC inhibitors block this activity by altering the genes to make cancer cells die. They also modify the body’s immune response to cancer cells and kill them.
Some examples of HDAC inhibitors include:
- Romidepsin (ISTODAX)
- Vorinostat (Zolinza)
Romidepsin
Romidepsin is an antineoplastic agent that belongs to the class of drugs known as histone deacetylase (HDAC) inhibitors.
Romidepsin is isolated from a bacterium called Chromobacterium violaceum and is thought to reduce the growth and division of lymphoma cells by inhibiting the process involved in the regulation in these lymphomas.
Indications for use in lymphoma
Patients with peripheral T-cell lymphoma and cutaneous T-cell lymphoma who have received at least one prior therapy.
Romidepsin is TGA registered in Australia for use, but it is not PBS listed (funded). Your doctor can apply with the pharmaceutical company to apply for compassionate funding with the pharmaceutical company.
How is it given?
- Romidepsin is given by intravenous infusion which means it goes directly into the vein through a needle in your arm or through a central line if you have one in place.
- Administered intravenously over a 4-hour period.
- Romidepsin is given every week for three weeks then a week off the medicine to complete a four-week cycle.
- Number of cycles given will depend on your subtype and disease status of lymphoma.
Possible side effects
- Diarrhoea
- Infections
- Low blood counts
- Nausea
- Tiredness
Vorinostat (Zolinza)
Vorinostat is a targeted therapy thought to work by reducing the growth and division of lymphoma cells, a process in the DNA which is involved in the gene regulation in these lymphomas.
Indications of use in lymphoma
Vorinostat is approved by the TGA and PBS funded for the following indications:
- Cutaneous T-cell lymphoma in patients with relapsed or chemotherapy-refractory disease
How is it given?
- Vorinostat is an oral capsule that you take every day.
- Administer orally ONCE daily with food
- To be swallowed whole with a glass of water
- Do not break, crush or chew
- You are encouraged to maintain a fluid intake (8 -10 glasses per day) unless fluid restricted
- Missed doses should not be replaced
- If a dose is forgotten or vomited, normal dosing should be resumed at the next scheduled dose.
- Treatment may be continued as long as there is no evidence of progressive disease or unacceptable toxicity.
Possible side effects
- Diarrhoea
- Infections
- Low blood counts-
- Thrombocytopenia and anaemia
- Nausea and vomiting
- Tiredness
- Anorexia
- Weight loss
- Taste disturbances
- Hair loss
- Muscle spasms
- Chills
