DR VOSE: So belinostat is one of the newer HDAC inhibitors. It was presented at ASCO by Dr O’Connor and also was presented at Lugano by Horwitz, kind of a subset analysis. So this medication is given intravenously for 5 days out of 7. And this particular study was the Phase II study, so it was fairly large, of 129 patients of different types of relapsed/refractory T-cell lymphoma. What they found overall was 26% overall response rate, but the complete response rate was fairly low. Most of those were partial responses.
And the toxicity was actually fairly well tolerated. It looked like, in a crude comparison, that the hematologic toxicity was less with this agent, particularly thrombocytopenia, as compared to some of the other HDACs. So that was an area of interest.
Also in the subset analysis that was looked at at Lugano by Steve Horwitz, he kind of subsetted out the different histologic types of lymphoma. And it was found that, also, in this study, the angioimmunoblastic patients seemed to have a higher response rate. And that was kind of an usual outcome from this. So interesting data. Will have to be looked at in a head-to-head comparison, obviously, for going forward.
DR LOVE: Mike, any thoughts about where things are heading in terms of belinostat and HDAC inhibitors in T-cell lymphoma?
DR WILLIAMS: So the combinations are of interest either putting it with the more traditional cytotoxic regimens — there’s also intriguing data and I don’t know much about the preclinical and early clinical work combining HDAC inhibitors with, say, proteasome inhibitors. Steve Grant at Virginia Commonwealth has done some work looking at those. And there’s some synergy and interest in moving those into the clinic. They’re being looked at in early phase studies right now. I’m not sure if you’re doing some of those with CALGB alliance.
DR FRIEDBERG: In our SPORE, we did a trial of carfilzomib and vorinostat that was for B-cell lymphoma. Again, we’re still putting the data together. I would say there wasn’t a tremendously big signal. And he has had a bortezomib and vorinostat study, which looked a little bit more appealing, particularly in mantle-cell lymphoma. But I think it’s a rational combination to explore.
DR EVENS: There is an ongoing romidepsin trial with CHOP or CHOEP that the GELA is looking at.
DR VOSE: It’s CHOP for their study.