II. Indications

  1. Peripheral T Cell Lymphoma (refractory or resistant)

III. Mechanism

  1. Antimetabolite, Antineoplastic Agent
  2. Belinostat inhibits tumor cell division, differentiation and Angiogenesis
    1. Histone Deacetylase Inhibitor (HDAC Inhibitor, hydroxamic acid-type)
    2. Histones are the spools around which DNA are wrapped, and which play a role in gene expression
      1. Cancers may be facilitated by abnormally expressed genes in specific histone regions
    3. HDAC Inhibitors block histone deacetylase
      1. Histone deacetylase is an enzyme that catalyzes removal of acetyl groups from core histones
      2. Results in hyperacetylation of histones, suppressing gene expression and cell differentiation
  3. Belinostat may also down regulate thymidylate synthase
    1. Sensitizes resistant tumor cells to other antineoplastics

IV. Medications

  1. Belinostat powder 500 mg for injection

V. Dosing

  1. Adult: 1000 mg/m2 IV daily on days 1 to 5 of a 21 day Chemotherapy cycle

VI. Adverse Effects

VII. Safety

  1. Avoid in Pregnancy (any trimester)
    1. Fetal toxicity
    2. Use reliable Contraception
  2. Unknown safety in Lactation
  3. Monitoring
    1. Complete Blood Count
    2. Liver Function Tests

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