Panobinostat First HDAC Inhibitor Approved by the FDA for the Treatment of Patients with Multiple Myeloma
On February 23, 2015, the FDA approved panobinostat (Farydak; Novartis Pharmaceuticals) for the treatment of patients with multiple myeloma. Panobinostat works by inhibiting the histone deacetylase (HDAC) enzymes, which slow and/or kill the excess production of plasma cells in the bone marrow that leads to the development of multiple myeloma.
Although the majority of patients with multiple myeloma report being involved in making decisions pertaining to their care, approximately 50% of them also believe they lack sufficient knowledge about their disease to be fully conversant with their physicians.
n patients with smoldering multiple myeloma, antitumor treatment alone (primarily with an immunomodulating agent) or in combination with bisphosphonates improves survival compared with observation alone, according to a meta-analysis of pharmacotherapy trials.
Histone deacetylase (HDAC) inhibitors may become a promising component of the treatment of multiple myeloma, based their unique mechanism of action and cytotoxic synergy with other agents. Several studies presented at the 2014 American Society of Hematology meeting evaluated the safety and efficacy of panobinostat in combination with established agents.
“In the era of novel agents, one size does not fit all” in terms of induction and autologous stem-cell transplant (ASCT), said Paul G. Richardson, MD, Director of Clinical Research, Dana-Farber Cancer Institute, Boston, who spoke at a special session on transplantation in multiple myeloma at the American Society of Hematology annual meeting.
At the time of the report, 50% of the patients were still receiving maintenance therapy. The estimated percentage of patients surviving without progression at 2 years is 57%. Serious adverse events were observed in 4 (19%) patients during maintenance with ixazomib, none of which were considered to be related to treatment.
Studies in multiple myeloma were a high priority among attendees at the 2014 American Society of Hematology (ASH) Annual Meeting in December. Attendance at the meeting’s oral sessions on myeloma was “standing room only” to hear research presentations, including studies on currently available drugs for the treatment of patients with myeloma.
Monoclonal antibodies may be to multiple myeloma what rituximab (Rituxan) has been to lymphoma, according to myeloma experts who expressed enthusiasm over these emerging agents at the 2014 American Society of Hematology Annual Meeting in December.
Shifts are rapidly occurring in the field of multiple myeloma, and they affect the management of patients from diagnosis through multiple relapses. Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant Service at Memorial Sloan Kettering Cancer Center, NY, discussed his treatment approach for various patient subgroups.
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