Optimal Management of Histone Deacetylase Inhibitor-Related Adverse Events in Patients With Multiple Myeloma: A Focus on Panobinostat

Clin Lymphoma Myeloma Leuk. 2018 Aug;18(8):501-507. doi: 10.1016/j.clml.2018.05.007. Epub 2018 May 24.

Abstract

Recent advances in treatment have extended the survival of patients with multiple myeloma. This improvement in itself poses challenges because of the length of time that patients live with myeloma, its physical complications, and toxicities of treatment. Thus, improvements in maintaining quality of life are essential, and part of this challenge involves learning how to optimally use new therapeutic agents. Panobinostat is the first histone deacetylase inhibitor approved for the treatment of multiple myeloma. It is approved for use in combination with bortezomib and dexamethasone for the treatment of patients with relapsed or relapsed and refractory multiple myeloma who have received ≥ 2 previous regimens, including bortezomib and an immunomodulatory drug. In this review multiple myeloma-related symptoms and adverse events resulting from treatments for multiple myeloma are discussed, with a focus on adverse events related to histone deacetylase inhibitors and histone deacetylase inhibitor combinations. The contribution of myeloma to these adverse events is discussed as well as how these AEs can best be managed.

Keywords: HDAC; Myelosuppression; Quality of life; Supportive care; Symptom management.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Histone Deacetylase 6 / antagonists & inhibitors*
  • Histone Deacetylase 6 / metabolism
  • Histone Deacetylase Inhibitors / adverse effects*
  • Humans
  • Molecular Targeted Therapy / adverse effects*
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / enzymology
  • Multiple Myeloma / mortality
  • Panobinostat / adverse effects*
  • Risk Factors
  • Treatment Outcome

Substances

  • Histone Deacetylase Inhibitors
  • Panobinostat
  • HDAC6 protein, human
  • Histone Deacetylase 6