Phase II multi-institutional trial of the histone deacetylase inhibitor romidepsin as monotherapy for patients with cutaneous T-cell lymphoma.

PURPOSE Romidepsin (depsipeptide or FK228) is a member of a new class of antineoplastic agents active in T-cell lymphoma, the histone deacetylase inhibitors. On the basis of observed responses in a phase I trial, a phase II trial of romidepsin in patients with T-cell lymphoma was initiated. PATIENTS AND METHODS The initial cohort was limited to patients with cutaneous T-cell lymphoma (CTCL), or subtypes mycosis fungoides or Sézary syndrome, who had received no more than two prior cytotoxic regimens. There were no limits on other types of therapy. Subsequently, the protocol was expanded to enroll patients who had received more than two prior cytotoxic regimens. Results Twenty-seven patients were enrolled onto the first cohort, and a total of 71 patients are included in this analysis. These patients had undergone a median of four prior treatments, and 62 patients (87%) had advanced-stage disease (stage IIB, n = 15; stage III, n= 6; or stage IV, n = 41). Toxicities included nausea, vomiting, fatigue, and transient thrombocytopenia and granulocytopenia. Pharmacokinetics were evaluated with the first administration of romidepsin. Complete responses were observed in four patients, and partial responses were observed in 20 patients for an overall response rate of 34% (95% CI, 23% to 46%). The median duration of response was 13.7 months. CONCLUSION The histone deacetylase inhibitor romidepsin has single-agent clinical activity with significant and durable responses in patients with CTCL.
AuthorsRichard L Piekarz, Robin Frye, Maria Turner, John J Wright, Steven L Allen, Mark H Kirschbaum, Jasmine Zain, H Miles Prince, John P Leonard, Larisa J Geskin, Craig Reeder, David Joske, William D Figg, Erin R Gardner, Seth M Steinberg, Elaine S Jaffe, Maryalice Stetler-Stevenson, Stephen Lade, A Tito Fojo, Susan E Bates
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 27 Issue 32 Pg. 5410-7 (Nov 10 2009) ISSN: 1527-7755 [Electronic] United States
PMID19826128 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, N.I.H., Intramural, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibiotics, Antineoplastic
  • Depsipeptides
  • Histone Deacetylase Inhibitors
  • romidepsin
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibiotics, Antineoplastic (adverse effects, pharmacokinetics, therapeutic use)
  • Area Under Curve
  • Depsipeptides (adverse effects, pharmacokinetics, therapeutic use)
  • Fatigue (chemically induced)
  • Female
  • Histone Deacetylase Inhibitors (adverse effects, pharmacokinetics, therapeutic use)
  • Humans
  • Leukemia (chemically induced)
  • Lymphoma, T-Cell, Cutaneous (drug therapy, pathology)
  • Male
  • Metabolic Clearance Rate
  • Middle Aged
  • Nausea (chemically induced)
  • Thrombocytopenia (chemically induced)
  • Treatment Outcome

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