Drugs

Panobinostat

Panobinostat

Other Names: Farydak, LBH589, PNB, panobinostat lactate Drug Class: Latency-Reversing Agents Molecular Formula: C21 H23 N3 O2 Registry Number: 404950-80-7 (CAS) Chemical Name: 2-Propenamide, N-hydroxy-3-(4-(((2-(2-methyl-1H-indol-3-yl)ethyl)amino)methyl)phenyl)-, (2E)- Chemical Class: Hydroxamic acid Organization: Novartis Pharmaceuticals Corporation Phase of Development: Panobinostat is in Phase I/II development as a latency-reversing agent for HIV treatment.

(Compound details obtained from ChemIDplus Advanced,1 Treatment Action Group website,2 Farydak Full Prescribing Information,3 Journal of Biomedicine and Biotechnology article,4 and ClinicalTrials.gov5)

What is panobinostat?

What is panobinostat?

Panobinostat is being investigated (studied) as part of a strategy to cure HIV infection. As an HIV investigational drug, panobinostat belongs to a general group of drugs called latency-reversing agents.5,6

Panobinostat is currently approved by the U.S. Food and Drug Administration (FDA) under the brand name Farydak for the treatment of a certain type of cancer.3

To learn about how investigational drugs are tested during clinical trials, read the AIDSinfo What is an Investigational HIV Drug? and HIV/AIDS Clinical Trials fact sheets.

How do latency-reversing agents work?

How do latency-reversing agents work?

Currently, there is no cure for HIV infection. One of the main obstacles to curing HIV infection is that the virus can remain hidden and inactive (latent) inside certain cells of the immune system (such as resting CD4 cells) for many months or even years. The cells where latent HIV hides are known as the latent HIV reservoir. Because HIV in this latent state is inactive, the immune system cannot detect the virus, and the antiretroviral (ARV) drugs that are used to treat HIV have no effect on it.7–9

Latency-reversing agents work by drawing HIV out of its latent state within resting CD4 cells. Once the latent HIV is reactivated, the CD4 cells that harbor the virus may more likely be recognized and killed by the body’s immune system or may be killed by certain HIV therapies, such as those that can enhance the body’s immune response to HIV. Researchers hope that the combined use of panobinostat and other HIV-fighting strategies, including ongoing antiretroviral therapy (ART), may fully eliminate HIV from the body.7–9 To learn more, see the AIDSinfo What is a Latent HIV Reservoir? fact sheet.

Which clinical trials are studying panobinostat?

Which clinical trials are studying panobinostat?

Study Names: CLEAR; NCT01680094
Phase: I/II
Status:This study has been completed.
Location: Denmark
Purpose: The purpose of this study was to evaluate the safety and effectiveness of panobinostat in reactivating latent HIV within resting CD4 cells.6

Study Names: ACTIVATE; NCT02471430
Phase: I/II
Status: This study is currently recruiting participants.
Location: United States
Purpose: The purpose of this study is to evaluate whether a combination of the HDAC inhibitor panobinostat and the immunomodulator peginterferon alfa-2a (brand name: Pegasys) can reduce latent HIV reservoirs.5

For more details on the studies listed above, see the Health Professional version of this drug summary.

What side effects might panobinostat cause?

What side effects might panobinostat cause?

One goal of HIV research is to identify new drugs that have fewer side effects. In the CLEAR study (NCT01680094), all panobinostat-related side effects were considered mild in severity. The most common side effect related to panobinostat was fatigue. Some minor changes in white blood cell counts and platelet counts were seen, but the changes were temporary.10

Because panobinostat is still being studied, information on possible side effects of the drug is not complete. As testing of panobinostat continues, additional information on possible side effects will be gathered.

Additional side effects known to be associated with panobinostat are described in the FDA-approved Full Prescribing Information for Farydak.

Where can I get more information about clinical trials studying panobinostat?

Where can I get more information about clinical trials studying panobinostat?

More information about panobinostat-related research studies is available from the AIDSinfo database of ClinicalTrials.gov study summaries. Click on the title of any trial in the list to see the ClinicalTrials.gov trial summary and more information about the study.

Some clinical trials may be looking for volunteer participants. Your health care provider can help you decide whether participating in a clinical trial is right for you. For information, visit NIH Clinical Research Trials and You.

References

References

  1. United States National Library of Medicine. ChemIDplus Advanced: Panobinostat. https://chem.nlm.nih.gov/chemidplus/rn/404950-80-7. Accessed March 22, 2019.
  2. Treatment Action Group website. Research toward a cure trials. http://www.treatmentactiongroup.org/cure/trials. Accessed March 22, 2019.
  3. Novartis Pharmaceuticals Corporation. Farydak: full prescribing information, December 2018. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7774972a-eeaa-4b9a-9e56-3fc1b968e86a. Accessed March 22, 2019.
  4. Masetti R, Serravalle S, Biagi C, Pession A. The role of HDACs inhibitors in childhood and adolescence acute leukemias. J Biomed Biotechnol. Article ID 148046 2011. doi:10.1155/2011/148046
  5. Massachusetts General Hospital. A Phase I-II pilot study to assess the safety and efficacy of combined administration with pegylated interferon-alpha2a and the histone deacetylase inhibitor (HDACi) panobinostat for reducing the residual reservoir of HIV-1 infected cells in cART-treated HIV-1 positive individuals. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on June 11, 2015. NLM Identifier: NCT02471430. https://clinicaltrials.gov/ct2/show/NCT02471430. Accessed March 22, 2019.
  6. University of Aarhus. The safety and efficacy of the histone deacetylase inhibitor panobinostat for purging HIV-1 from the latent reservoir (CLEAR) study. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on September 3, 2012. NLM Identifier: NCT01680094. https://clinicaltrials.gov/ct2/show/NCT01680094. Accessed March 22, 2019.
  7. Siliciano RF, Greene WC. HIV latency. Cold Spring Harb Perspect Med. 2011;1(1):a007096.
  8. Rasmussen TA, Tolstrup M, Winckelmann A, Østergaard L, Søgaard OS. Eliminating the latent HIV reservoir by reactivation strategies. Hum Vaccines Immunother. 2013;9(4):790–799.
  9. National Institute of Allergy and Infectious Diseases (NIAID). HIV viral eradication. https://www.niaid.nih.gov/diseases-conditions/hiv-viral-eradication. Accessed March 22, 2019.
  10. Rasmussen TA, Tolstrup M, Brinkmann CR, et al. Panobinostat, a histone deacetylase inhibitor, for latent-virus reactivation in HIV-infected patients on suppressive antiretroviral therapy: a Phase 1/2, single group, clinical trial. Lancet HIV. 2014;1(1):e13-21. doi:10.1016/S2352-3018(14)70014-1

Last Reviewed: March 22, 2019

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