Common brand names

• Istodax

How it is administered

Romidepsin is given as an intravenous (IV) infusion. It is supplied as a sterile powder that must be reconstituted with a special diluent and then further diluted with saline before being administered.

The typical dosing schedule is 14 mg/m² administered over a 4-hour period on days 1, 8, and 15 of a 28-day cycle. The cycle can be repeated every 28 days as long as the patient continues to benefit and tolerate the medication.

How it works

Romidepsin is a histone deacetylase (HDAC) inhibitor. HDACs are enzymes that remove acetyl groups from certain proteins, including histones, which are involved in packaging DNA inside cells. By inhibiting HDACs, romidepsin causes an accumulation of acetylated histones, which can change the way genes are expressed in cells.

This change in gene expression can lead to cell cycle arrest (stopping cells from dividing) and apoptosis (programmed cell death) in cancer cells. While the exact way romidepsin works to fight cancer is not fully understood, its ability to alter gene expression and promote cancer cell death is believed to be key to its effectiveness, particularly in certain types of blood cancers like cutaneous T-cell lymphoma (CTCL).

Who should take it

Romidepsin is indicated for adults with cutaneous T-cell lymphoma (CTCL) who have already received at least one prior systemic therapy. CTCL is a type of non-Hodgkin lymphoma that primarily affects the skin but can also involve lymph nodes and other organs.

This medication is generally considered when other treatments have not worked or are no longer effective. Your doctor will determine if romidepsin is appropriate for you based on your specific diagnosis, previous treatments, and overall health.

Who should not take it

There are no absolute contraindications listed for romidepsin. However, it should be used with caution in certain patients:

• Pregnant women, as it can cause harm to an unborn baby.
• Patients with a history of significant cardiovascular disease or congenital long QT syndrome, as romidepsin can cause changes in heart rhythm.
• Patients with active, serious infections or those at high risk for infections, as romidepsin can lower blood counts and increase infection risk.

Always discuss your full medical history with your doctor before starting romidepsin.

Commonly used with

Romidepsin is most often used as a single agent (by itself) for the treatment of cutaneous T-cell lymphoma. However, in some cases, your doctor may consider combining it with other supportive medications, such as anti-nausea drugs or antibiotics, to help manage side effects or prevent infections.

Commonly tested with

Romidepsin has been tested in combination with other medications in clinical trials, but for CTCL, it is primarily studied and approved as a single agent. In research settings, it may be tested with other chemotherapy drugs or targeted therapies, but this is not standard practice for routine treatment of CTCL.