Belinostat for Peripheral T-Cell Lymphoma

The majority of patients with peripheral T-cell lymphoma (PTCL) will either be refractory or relapse to the currently available frontline therapies with a subsequent median overall survival <6 months. Histone deacetylase (HDAC) inhibitors have demonstrated significant activity in T-cell neoplasms, and recently the BELIEF trial of belinostat (Beleodaq), a pan-HDAC inhibitor with high affinity for class I and II HDACs, was completed in relapsed/refractory PTCL. This study demonstrated a complete response rate of 11%, with an overall response rate of 26%. These results have been confirmed in a smaller trial that also included patients with cutaneous T-cell lymphomas. Given the similar response rates achieved by pralatrexate (Folotyn) and romidepsin (Istodax), belinostat has become the third agent approved by the US Food and Drug Administration for use in relapsed/refractory PTCL, thus providing another option for patients with these aggressive malignancies.