An Open-label Phase 2 Study of Intravenous Bortezomib and Oral Panobinostat (LBH589) in Adult Patients With Relapsed/Refractory Peripheral T-cell Lymphoma or NK/T-cell Lymphoma After Failure of Conventional Chemotherapy
Peripheral T-cell lymphoma (PTCL) and NK/T-cell lymphoma are uncommon diseases that are
prevalent in Asia. They are associated with poor prognosis when treated with conventional
chemotherapeutic regimes. Their long term disease-free survivals are dismal with only 10-30%
of patients surviving long term. More intensive regimens including high dose chemotherapy
with autologous stem cell transplant have been tried as primary induction treatment, but
have not been shown to be beneficial. Given the rarity of PTCL and NK/T-cell lymphoma, much
of the literature consists of studies with small sample size and anecdotal case reports.
Therefore, no consensus exists on the best therapeutic strategy for either newly diagnosed
or relapsed disease. The failure of conventional chemotherapy in this regard suggests that
novel therapies including epigenetic approaches and proteasome inhibition should be
explored.
Preclinical data of bortezomib and histone deacetylase inhibitors (HDIs) in T-cell and
NK/T-cell lymphoma cell lines are encouraging. Bortezomib and HDIs have also separately
demonstrated activity in T and NK/T-cell lymphomas in phase II studies, leading to their
separate developments in phase III studies. Demonstration of synergism in these 2 agents, in
part due to their dependence on overlapping pathways, suggests that they should be explored
as a combination, especially when treating a disease with a very unfavourable outcome. The
purpose of this phase II study is to assess the efficacy of orally-administered
panobinostat, a potent class I/II pan-deacetylase inhibitor with intravenous bortezomib in
this patient population.
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Objective Response Rate
1 year
No
Daryl Tan, MBBS MRCP
Principal Investigator
Singapore General Hospital
Singapore: Health Sciences Authority
SGH651
NCT00901147
November 2009
June 2011
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