Panobinostat Promising in Relapsed/Refractory Hodgkin’s Lymphoma

An ongoing study of the experimental drug panobinostat (LBH-589) reports promising activity in heavily pretreated patients with relapsed and refractory Hodgkin’s lymphoma (HL). These findings were presented at the 2010 annual meeting of the American Society of Clinical Oncology.

Hodgkin’s lymphoma is a cancer of the lymph system. It is diagnosed by the presence of a cell that is characteristic of the disease, the Reed-Sternberg cell. Hodgkin’s lymphoma typically begins in the lymph nodes in one region of the body and then spreads throughout the lymph system. It may spread outside the lymph system to other organs, such as the lungs, liver, bone, and bone marrow.

Hodgkin’s lymphoma that returns following prior therapy is considered relapsed, or recurrent, disease. Hodgkin’s lymphoma that does not respond to standard therapies is considered refractory disease. Patients with relapsed and refractory HL may be treated with high doses of chemotherapy and stem cell transplant (SCT).

Panobinostat is a drug known as a pan-deacetylase inhibitor. In HL, panobinostat works against cancer by decreasing cell proliferation, or growth, and inducing apoptosis, or cell death. In addition to HL, Phase II and III clinical trials of panobinostat are also underway in diseases including cutaneous T-cell lymphoma, chronic myelogenous leukemia, myelodysplastic syndromes, breast cancer, and prostate cancer. In earlier research, panobinostat has appeared promising in the treatment of HL.

In the current, ongoing study, an international Phase II trial, panobinostat is being evaluated in129 patients with relapsed and refractory HL who have been heavily pretreated. Previous treatment has included autologous SCT and up to five chemotherapy regimens. Panobinostat has been given at a 40 mg dose three times per week during 21-day cycles. Response to treatment has been monitored using CT and MRI scans after every two cycles of therapy.

  • 3% of patients have had a complete response to treatment, and 22% have had a partial response to treatment (a 50% or greater reduction in the amount of detectable cancer).
  • The most common side effect in the study has been thrombocytopenia (a decrease in the number of platelets in the blood), which had not been severe enough to interrupt treatment in the majority of patients.

The researchers conclude that among patients with relapsed and refractory HL who have been heavily pretreated, panobinostat appears active and is well tolerated. This is an ongoing study, and further findings are expected.

Reference: Sureda A, Engert A, Browett PJ, et al. Interim results for the phase II study of panobinostat (LBH589) in patients (Pts) with relapsed/refractory Hodgkin’s lymphoma (HL) after autologous hematopoietic stem cell transplant (AHSCT). Presented at the 2010 annual meeting of the American Society of Clinical Oncology, June 4-8, 2010, Chicago, IL. Abstract 8007.

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