How it is administered

Romidepsin is given as an intravenous (IV) infusion. It comes as a sterile powder that is reconstituted with a special diluent and then further diluted with saline before being infused into a vein. The usual dose is 14 mg/m² administered over a 4-hour period on days 1, 8, and 15 of a 28-day cycle. The cycle is repeated every 28 days as long as the patient continues to benefit and tolerate the medication.

How it works

Romidepsin is a type of medication known as a histone deacetylase (HDAC) inhibitor. HDACs are enzymes that help control the way genes are expressed in cells. By inhibiting these enzymes, romidepsin causes an accumulation of acetylated histones, which can change the expression of certain genes. This leads to cell cycle arrest and programmed cell death (apoptosis) in some cancer cells.

Although the exact way romidepsin works to fight cancer is not fully understood, it is believed that by altering gene expression, it can stop the growth and spread of cancer cells, particularly in certain types of T-cell lymphomas. Romidepsin is especially used in blood cancers like cutaneous T-cell lymphoma (CTCL) and has also been studied in peripheral T-cell lymphoma (PTCL).

Who Should take it

Romidepsin is indicated for adults with cutaneous T-cell lymphoma (CTCL) who have received at least one prior systemic therapy. While it is not currently FDA-approved specifically for peripheral T-cell lymphoma (PTCL), it has been studied in this condition, and some patients with PTCL may receive it as part of their treatment plan, especially if other therapies have not worked.

Patients who have tried other systemic treatments for CTCL and need additional options may benefit from romidepsin. Your doctor will determine if this medication is appropriate for your specific type of blood cancer and treatment history.

Who should not take it

There are no absolute contraindications listed for romidepsin, but it should be used with caution in certain situations. Women who are pregnant should not take romidepsin because it can cause harm to the unborn baby. Both women and men of reproductive potential should use effective contraception during treatment and for at least one month after the last dose.

Patients with significant heart problems, such as congenital long QT syndrome or a history of serious heart disease, should be carefully monitored if they receive romidepsin. It should also be used cautiously in people with active infections or those who have had hepatitis B or Epstein-Barr virus, as it can cause reactivation of these viruses.

Commonly used with

Romidepsin is typically used as a single agent for CTCL, especially in patients who have already tried other treatments. In some cases, it may be combined with other medications as part of a clinical trial or specialized treatment plan, but its main use is as a stand-alone therapy for relapsed or refractory T-cell lymphomas.

Commonly tested with

Romidepsin has been studied in combination with other chemotherapies and targeted agents in clinical trials for T-cell lymphomas, including agents like CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) and other investigational drugs. However, its primary FDA-approved use is as a single agent, and combinations are generally considered in research settings or specific clinical scenarios.