Zolinza (vorinostat), a drug already approved for cutaneous T-cell lymphoma, is currently undergoing clinical trials for the treatment of multiple myeloma.  Preliminary results look encouraging.

The drug is the first in a class called histone deacetylase (HDAC) inhibitors to be approved for cancer treatment.

The majority of chemotherapy drugs work by attacking cancer cell DNA with the intention of damaging it. HDAC inhibitors work differently. They alter the way DNA is converted into proteins.

DNA is arranged in chromosomes, which wrap around proteins called histones. HDAC helps control the unfolding of DNA from histones—an initial step in the production of protein from DNA. Inhibiting HDAC increases the production of protein.

With Zolinza, researchers hope to inhibit HDAC in a way that increases the production of proteins that slow cell division, repair DNA mistakes, and control cell death. This, in turn, should help the body prevent cells from growing out of control and becoming cancerous.

Clinical trials of Zolinza administered alone have shown modest activity in myeloma patients, suggesting more studies are necessary.  The drug has also been tested in combination with Revlimid (lenalidomide) and Velcade (bortezomib), generating positive results.

In particular, Zolinza in combination with Velcade benefitted relapsed/refractory myeloma patients who had few prior therapies as well as those who had been heavily pretreated.  Data from several studies also indicate that safety and tolerance levels for Zolinza are acceptable.

Larger, international, multi-center trials are currently underway for the use of Zolinza with Velcade.  If the trials are successful, researchers hope the drug will be approved for use in multiple myeloma.

For more information, see the article "The Role of Zolinza in Multiple Myeloma" in the Fall 2008 issue of Myeloma Today (pdf).