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Entinostat: a promising treatment option for patients with advanced breast cancer
Roisin M Connolly1, Michelle A Rudek1, Richard Piekarz2
1Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Abstract:
Entinostat is a synthetic benzamide derivative histone deacetylase (HDAC) inhibitor, which potently and selectively inhibits class I and IV HDAC enzymes. This action promotes histone hyperacetylation and transcriptional activation of specific genes, with subsequent inhibition of cell proliferation, terminal differentiation and apoptosis. This oral HDAC inhibitor has been evaluated in Phase I and II trials in patients with advanced malignancies, and is in general well tolerated. Entinostat does not currently have regulatory approval for clinical use; however promising preclinical and clinical data exist in hormone-resistant breast cancer. An ECOG-ACRIN Phase III registration study is ongoing in advanced breast cancer (E2112, NCT02115282) and aims to confirm the overall survival advantage observed with the combination of exemestane and entinostat/placebo in the Phase II setting (ENCORE301 trial). This article provides an overview of the chemistry, pharmacokinetics/pharmacodynamics and available clinical data for entinostat with a focus on advanced breast cancer.
Insights
Entinostat, a histone deacetylase (HDAC) inhibitor, shows promise in advanced breast cancer treatment. Ongoing Phase III trials aim to confirm its survival benefits when combined with exemestane.
Area of Science:
- Pharmacology
- Oncology
- Molecular Biology
Background:
- Entinostat is a synthetic benzamide derivative and a potent, selective inhibitor of histone deacetylase (HDAC) class I and IV enzymes.
- HDAC inhibition leads to histone hyperacetylation, transcriptional activation, and subsequent inhibition of cell proliferation, promoting terminal differentiation and apoptosis.
Purpose of the Study:
- To provide an overview of entinostat's chemistry, pharmacokinetics, pharmacodynamics, and clinical data.
- To focus on entinostat's potential in treating advanced breast cancer, particularly hormone-resistant types.
Main Methods:
- Review of preclinical and clinical data for entinostat.
- Overview of ongoing Phase III registration study (E2112, NCT02115282) in advanced breast cancer.
Main Results:
- Entinostat has been evaluated in Phase I and II trials for advanced malignancies and is generally well tolerated.
- Promising preclinical and clinical data exist for entinostat in hormone-resistant breast cancer.
Conclusions:
- Entinostat is an orally available HDAC inhibitor with potential in advanced breast cancer.
- Further confirmation of overall survival advantage is being investigated in a Phase III trial combining entinostat with exemestane.
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