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Panobinostat for the Treatment of Multiple Myeloma

Jacob P Laubach1, Philippe Moreau2, Jesús F San-Miguel3

  • 1Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.

Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
|September 13, 2015
PubMed

Insights

Panobinostat, a deacetylase inhibitor, combined with bortezomib and dexamethasone, significantly improved progression-free survival in relapsed or refractory multiple myeloma patients. This combination therapy offers a new treatment option for advanced multiple myeloma.

Area of Science:

  • Oncology
  • Pharmacology
  • Epigenetics

Background:

  • Panobinostat is a potent oral deacetylase inhibitor impacting gene expression and protein degradation.
  • It is approved for relapsed or refractory multiple myeloma in combination with bortezomib and dexamethasone.
  • This regimen is for patients who have undergone at least two prior treatments, including bortezomib and an immunomodulatory drug.

Purpose of the Study:

  • To review panobinostat's mechanism of action, pharmacokinetics, and clinical efficacy.
  • To focus on its use in treating relapsed or relapsed and refractory multiple myeloma.
  • To discuss its role in combination therapy for multiple myeloma.

Main Methods:

  • Review of clinical trial data, focusing on the Phase III PANORAMA 1 trial.
  • Analysis of progression-free survival (PFS) data.
  • Examination of panobinostat's pharmacokinetic profile and mechanism of action.

Main Results:

  • Panobinostat plus bortezomib and dexamethasone significantly extended PFS (12.0 months) versus placebo plus bortezomib and dexamethasone (8.1 months) in relapsed/refractory multiple myeloma (P < 0.0001).
  • The study demonstrated a statistically significant improvement in PFS for the panobinostat combination arm.
  • Ongoing trials are exploring panobinostat in various combinations and patient populations.

Conclusions:

  • Panobinostat in combination therapy represents a significant advancement for relapsed or refractory multiple myeloma.
  • The drug's epigenetic mechanism offers a novel therapeutic approach.
  • Further research is evaluating its broader application in multiple myeloma treatment settings.

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