Owen A O'Connor1, Steven Horwitz2, Tamás Masszi2, Achiel Van Hoof2, Peter Brown2, Jeannette Doorduijn2, Georg Hess2, Wojciech Jurczak2, Poul Knoblauch2, Shanta Chawla2, Gajanan Bhat2, Mi Rim Choi2, Jan Walewski2, Kerry Savage2, Francine Foss2, Lee F Allen2, Andrei Shustov2. 1. Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA. oo2130@columbia.edu. 2. Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA.
Abstract
PURPOSE: Peripheral T-cell lymphomas (PTCLs) represent a diverse group of non-Hodgkin lymphomas with a poor prognosis and no accepted standard of care for patients with relapsed or refractory disease. This study evaluated the efficacy and tolerability of belinostat, a novel histone deacetylase inhibitor, as a single agent in relapsed or refractory PTCL. PATIENTS AND METHODS: Patients with confirmed PTCL who experienced progression after ≥ one prior therapy received belinostat 1,000 mg/m(2) as daily 30-minute infusions on days 1 to 5 every 21 days. Central assessment of response used International Working Group criteria. Primary end point was overall response rate. Secondary end points included duration of response (DoR) and progression-free and overall survival. RESULTS: A total of 129 patients were enrolled, with a median of two prior systemic therapies. Overall response rate in the 120 evaluable patients was 25.8% (31 of 120), including 13 complete (10.8%) and 18 partial responses (15%). Median DoR by International Working Group criteria was 13.6 months, with the longest ongoing patient at ≥ 36 months. Median progression-free and overall survival were 1.6 and 7.9 months, respectively. Twelve of the enrolled patients underwent stem-cell transplantation after belinostat monotherapy. The most common grade 3 to 4 adverse events were anemia (10.8%), thrombocytopenia (7%), dyspnea (6.2%), and neutropenia (6.2%). CONCLUSION: Monotherapy with belinostat produced complete and durable responses with manageable toxicity in patients with relapsed or refractory PTCL across the major subtypes, irrespective of number or type of prior therapies. These results have led to US Food and Drug Administration approval of belinostat for this indication.
PURPOSE: Peripheral T-cell lymphomas (PTCLs) represent a diverse group of non-Hodgkin lymphomas with a poor prognosis and no accepted standard of care for patients with relapsed or refractory disease. This study evaluated the efficacy and tolerability of belinostat, a novel histone deacetylase inhibitor, as a single agent in relapsed or refractory PTCL. PATIENTS AND METHODS: Patients with confirmed PTCL who experienced progression after ≥ one prior therapy received belinostat 1,000 mg/m(2) as daily 30-minute infusions on days 1 to 5 every 21 days. Central assessment of response used International Working Group criteria. Primary end point was overall response rate. Secondary end points included duration of response (DoR) and progression-free and overall survival. RESULTS: A total of 129 patients were enrolled, with a median of two prior systemic therapies. Overall response rate in the 120 evaluable patients was 25.8% (31 of 120), including 13 complete (10.8%) and 18 partial responses (15%). Median DoR by International Working Group criteria was 13.6 months, with the longest ongoing patient at ≥ 36 months. Median progression-free and overall survival were 1.6 and 7.9 months, respectively. Twelve of the enrolled patients underwent stem-cell transplantation after belinostat monotherapy. The most common grade 3 to 4 adverse events were anemia (10.8%), thrombocytopenia (7%), dyspnea (6.2%), and neutropenia (6.2%). CONCLUSION: Monotherapy with belinostat produced complete and durable responses with manageable toxicity in patients with relapsed or refractory PTCL across the major subtypes, irrespective of number or type of prior therapies. These results have led to US Food and Drug Administration approval of belinostat for this indication.
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