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Hematologic toxicity is rare in relapsed patients treated with belinostat: a systematic review of belinostat toxicity and safety in peripheral T-cell lymphomas

Authors Allen PB, Lechowicz MJ

Received 31 May 2018

Accepted for publication 1 September 2018

Published 6 December 2018 Volume 2018:10 Pages 6731—6742

DOI https://doi.org/10.2147/CMAR.S149241

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo


Video abstract presented by Pamela B Allen.

Pamela B Allen, Mary Jo Lechowicz

Department of Hematology and Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA

Abstract: 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.

Keywords: peripheral T-cell lymphoma, belinostat, histone deacetylase inhibitor, hematologic toxicity, anaplastic large cell lymphoma, angioimmunoblastic T-cell lymphoma, NK/T-cell lymphoma, cytopenia

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