Relapsed/Refactory Patients:

Panobinostat (LBH589)

What is Panobinostat?

Panobinostat is an oral anticancer agent being developed by Novartis that inhibits multiple enzymes that cancer cells need to grow and survive. It is known as a deacetylase (DAC) inhibitor, and is also known by the name LBH589. Panobinostat also inhibits the growth of new blood vessels needed for tumors to grow.

What do we know about Panobinostat’s activity in myeloma?

In the laboratory, panobinostat has been shown to kill myeloma cells, including those that are resistant to other anti-myeloma drugs. In addition, panobinostat acts synergistically with other anti-myeloma drugs, such as Velcade.

Panobinostat has been evaluated in several trials in myeloma, including two that were facilitated by the Multiple Myeloma Research Consortium (MMRC).

• A Phase II study of panobinostat in patients with advanced refractory myeloma showed the drug to be well-tolerated and safe. The dose used in this study was lower than that used in subsequent studies, but several responses were noted. 
• The safety of panobinostat in combination with Velcade was evaluated in a Phase I trial in relapsed or relapsed/refractory myeloma.
• Dexamethasone could be added in cases of worsening disease.
• Promising activity was seen in the 38 evaluable patients, with an overall response rate of 58%.
• Low platelet counts were the most common side effect seen.
• The maximum tolerated doses of combination Velcade and panobinostat were determined, and patients continue to receive these doses in an ongoing part of the study.
• The safety of panobinostat in combination with Revlimid-dex was also evaluated in a Phase I trial in relapsed or relapsed/refractory myeloma.

How is Panobinostat currently being studied in myeloma?

Panobinostat is currently being tested in several clinical trials in myeloma, including:

• A Phase III study in combination with Velcade-dex in patients with relapsed myeloma
• A Phase II study in combination with Velcade-dex in patients with relapsed disease that no longer responds to Velcade, which is set to begin
• A Phase I/II study in combination with melphalan in patients with relapsed or refractory myeloma
• A Phase I/II study in combination with Afinitor® (everolimus), a drug used in the treatment of kidney cancer, in patients with relapsed or refractory myeloma
• A Phase I  study that is evaluating an intravenous form of panobinostat in combination with Velcade in patients with relapsed/refractory myeloma

Click here to go to the MMRF Clinical Trial Matching Service.