belinostat

Contraindicated in:

OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

Advanced stage disease/large tumor burden (↑ risk of tumor lysis syndrome);
Patients with UGT1A1*28 polymorphism (initial dose ↓ required);
Moderate or severe renal impairment (CCr <39 mL/min);
Moderate/severe hepatic impairment;
Rep: Women of reproductive potential and men with female partners of reproductive potential;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypotension, peripheral edema, phlebitis

Derm: pruritus, rash

F and E: hypokalemia

GI: nausea, vomiting, abdominal pain, constipation, diarrhea, HEPATOTOXICITY

GU: ↓fertility (males), ↑serum creatinine

Hemat: leukopenia, ANEMIA, THROMBOCYTOPENIA

Local: infusion site pain

Metab: ↓appetite

Neuro: fatigue, dizziness, headache

Resp: cough

Misc: chills, tumor lysis syndrome, fever, INFECTION

Interactions ⬆ ⬇

Drug-drug:

Concurrent use of strong inhibitors of UGT1A1, including atazanvir and gemfibrozil, may ↑ levels and risk of serious toxicity; avoid concurrent use.

Availability ⬆ ⬇

Lyophilized powder for injection: 500 mg/vial

Route/Dosage ⬆ ⬇

IV (Adults ): 1000 mg/m²/day on days 1–5 of a 21-day cycle. Cycle may be repeated until disease progression or unacceptable toxicity. Patients with UGT1A1*28 polymorphism: 750 mg/m² on days 1–5 of a 21-day cycle. Cycle may be repeated until disease progression or unacceptable toxicity.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Acts as a histone deacetylase inhibitor, produces accumulation of acetylated histones and other proteins resulting in cell cycle arrest/apoptosis of cells; may have affinity for tumor cells.

Therapeutic effects:

Decreased spread of relapsed/refractory peripheral T-cell lymphoma.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: histone deacetylase inhibitors

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Minimally distributed to tissues.

Metabolism/Excretion: Primarily metabolized by the liver via the UGT1A1 enzyme system with minor metabolism by other systems; <2% excreted unchanged in urine.

Half-Life: 1.1 hr.

Time/Action Profile ⬆ ⬇

(response)

ROUTE	ONSET	PEAK	DURATION
IV	unknown	unknown	12 mo

Patient/Family Teaching ⬆ ⬇

Instruct patient to read the Patient Information sheet prior to starting therapy and with each cycle in case of changes.
Advise patient to notify health care professional if signs and symptoms of low platelet counts (unusual bleeding and bruising), low red blood cell count (weakness, tiredness, pale skin, dyspnea), infection (fever, flu-like symptoms, cough, shortness of breath, burning with urination, muscle aches, worsening skin problems), or liver problems (yellowing of skin and whites of eyes, dark urine, itching, pain in upper right stomach area) occur.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other Rx, OTC, or herbal products.
Rep: Advise females of reproductive potential to use effective contraception during and for 6 mo after last dose and to avoid breastfeeding during and for 2 wk after last dose. Advise males with female partners of reproductive potential to use effective contraception during and for 3 mo after last dose. May impair male fertility.
Emphasize the need for periodic lab tests to monitor for side effects.

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Indications ⬇

Contraind./Precautions ⬆ ⬇