Peripheral T-cell lymphomas (PTCLs) are an aggressive and diverse group of
lymphomas with a T-cell origin. Most patients progress following initial treatment and require
salvage therapy. The burden of symptoms is high due to its extra-nodal presentation, high rate of advanced disease, and associated
cytopenias combined with its predilection for an elderly population. The disease is generally incurable at relapse in the absence of
transplantation and treatment is aimed at prolonging life and reducing disease-related symptoms.
Belinostat is a
histone deacetylate inhibitor that was granted accelerated approval by the US Food and Drug Administration on July 3, 2014, for the treatment of relapsed PTCL. Here, a systemic review was conducted to assess the safety and efficacy of
belinostat. A safety analysis involved 512 patients with relapsed
malignancies, and an efficacy analysis focused on patients with relapsed PTCL and included a total of 144 patients. Common adverse events were noted including
fatigue (35%),
nausea (42.8%), and
vomiting (28.5%), but comparatively low rates of grade 3/4 hematologic toxicity overall (6.4%). Efficacy analysis demonstrated an overall response rate of 25.7% and complete responses of 10.4% with the majority of discontinuations occurring for lack of efficacy. Ultimately, these results demonstrate that
belinostat has comparable efficacy to other agents used in this setting and is well tolerated in regard to hematologic events, but there is limited data on patient-reported outcomes, reduction in disease-related symptoms, or quality of life.