What is Panobinostat: Uses, Dosage, Side Effects and More

Panobinostat is a targeted cancer medication that works by blocking specific proteins that help cancer cells grow and survive. It belongs to a class of drugs called histone deacetylase inhibitors, which essentially help your body's natural tumor-fighting mechanisms work more effectively. This medication is primarily used to treat certain types of blood cancers, particularly multiple myeloma when other treatments haven't worked as well as hoped.

What is Panobinostat?

Panobinostat is an oral cancer medication that targets cancer cells at the molecular level. It works by interfering with enzymes called histone deacetylases, which cancer cells need to grow and multiply.

Think of it as a medication that helps restore your body's natural ability to control abnormal cell growth. Unlike chemotherapy that affects all rapidly dividing cells, panobinostat is more selective in how it targets cancer cells. This targeted approach can make it effective while potentially causing fewer side effects than traditional chemotherapy.

The medication comes in capsule form and is taken by mouth, making it more convenient than treatments that require hospital visits for infusions. Your doctor will prescribe it as part of a comprehensive cancer treatment plan tailored specifically to your condition.

What is Panobinostat Used For?

Panobinostat is specifically approved to treat multiple myeloma, a type of blood cancer that affects plasma cells in your bone marrow. It's typically prescribed when you've already tried at least two other treatment approaches, including an immunomodulatory agent and a proteasome inhibitor.

Multiple myeloma can be challenging to treat because cancer cells often develop resistance to medications over time. Panobinostat offers a different mechanism of action, which means it can potentially help when other treatments have stopped working effectively.

Your oncologist might recommend panobinostat as part of combination therapy, usually paired with other medications like bortezomib and dexamethasone. This combination approach helps attack the cancer from multiple angles, potentially improving treatment outcomes.

How Does Panobinostat Work?

Panobinostat works by blocking enzymes called histone deacetylases (HDACs) that cancer cells need to control gene expression. When these enzymes are blocked, cancer cells can't properly regulate their growth and survival mechanisms.

This medication is considered a moderately strong cancer treatment with a targeted mechanism of action. It's designed to be potent enough to affect cancer cells while being more selective than traditional chemotherapy drugs.

The drug essentially helps restore normal cellular processes that cancer cells have disrupted. By interfering with these specific pathways, panobinostat can cause cancer cells to stop growing or even die, while having less impact on healthy cells throughout your body.

How Should I Take Panobinostat?

Take panobinostat exactly as your doctor prescribes, usually three times per week on specific days. The most common schedule is Monday, Wednesday, and Friday of weeks 1 and 2 of each 21-day treatment cycle.

You should take the capsules with water, and you can take them with or without food. However, taking them with food might help reduce stomach upset if you experience nausea. Don't crush, chew, or open the capsules - swallow them whole to ensure proper absorption.

It's important to take your doses at roughly the same time each day to maintain consistent levels of the medication in your system. If you vomit within an hour of taking a dose, don't take another dose that day - wait until your next scheduled dose.

Before starting treatment, your doctor will likely recommend eating a light meal or snack about 30 minutes before taking the medication. This can help minimize gastrointestinal side effects that some people experience.

How Long Should I Take Panobinostat For?

The duration of panobinostat treatment varies significantly from person to person and depends on how well the medication works for your specific situation. Most people continue treatment for as long as it's helping control their cancer and the side effects remain manageable.

Your doctor will monitor your response to treatment through regular blood tests, imaging studies, and physical examinations. These assessments help determine whether the medication is working effectively and whether it's safe for you to continue.

Some people may take panobinostat for several months, while others might continue for a year or longer. The key is finding the right balance between cancer control and quality of life. Your healthcare team will work with you to make adjustments as needed throughout your treatment journey.

What Are the Side Effects of Panobinostat?

Like all cancer medications, panobinostat can cause side effects, though not everyone experiences them. The most common side effects are generally manageable with proper medical support and monitoring.

Here are the more common side effects you might experience:

• Fatigue and weakness
• Nausea and vomiting
• Diarrhea
• Decreased appetite
• Low blood cell counts
• Swelling in hands, feet, or legs
• Muscle or joint pain

These side effects are usually mild to moderate and often improve as your body adjusts to the medication. Your healthcare team can provide strategies and medications to help manage these symptoms effectively.

More serious but less common side effects can include severe infections due to low white blood cell counts, heart rhythm problems, or severe diarrhea leading to dehydration. While these are rare, it's important to report any concerning symptoms to your doctor immediately.

Some people may experience blood clots, severe fatigue, or liver problems. Your doctor will monitor you closely with regular blood tests to catch any potential issues early and adjust your treatment if necessary.

Who Should Not Take Panobinostat?

Panobinostat isn't suitable for everyone, and your doctor will carefully evaluate whether it's right for you. People with certain heart conditions, particularly those with a history of irregular heartbeats or heart rhythm problems, may not be good candidates for this medication.

If you have severe liver problems or active, uncontrolled infections, your doctor will likely recommend waiting until these conditions are better controlled before starting panobinostat. The medication can affect your immune system, making infections more serious.

Pregnant or breastfeeding women should not take panobinostat, as it can harm developing babies. If you're of childbearing age, you'll need to use effective birth control during treatment and for several months after stopping the medication.

People with severe kidney problems or those taking certain medications that affect heart rhythm may also need alternative treatments. Your doctor will review all your current medications and health conditions to ensure panobinostat is safe for you.

Panobinostat Brand Names

Panobinostat is available under the brand name Farydak in most countries, including the United States. This is the primary brand name you'll see on your prescription bottle and medication packaging.

Currently, Farydak is the main brand available, as panobinostat is a relatively newer medication that's still under patent protection. Generic versions aren't yet widely available, though this may change in the future as patents expire.

When discussing your treatment with healthcare providers or pharmacists, you can refer to the medication by either name - panobinostat or Farydak - and they'll know exactly what you're talking about.

Panobinostat Alternatives

If panobinostat isn't suitable for you or stops working effectively, several alternative treatments are available for multiple myeloma. Your doctor might consider other histone deacetylase inhibitors or medications with different mechanisms of action.

Some alternatives include other targeted therapies like carfilzomib, pomalidomide, or daratumumab. These medications work through different pathways to attack cancer cells, offering options if panobinostat isn't the right fit for your situation.

Newer immunotherapy approaches, including CAR-T cell therapy, might also be options depending on your specific circumstances. Clinical trials investigating experimental treatments could provide additional possibilities for people who've tried multiple standard therapies.

The best alternative depends on your previous treatments, overall health, and specific characteristics of your cancer. Your oncologist will work with you to determine the most appropriate next steps if panobinostat isn't working or causing unacceptable side effects.

Is Panobinostat Better Than Bortezomib?

Panobinostat and bortezomib work through different mechanisms, so comparing them isn't straightforward. Bortezomib is a proteasome inhibitor that's often used earlier in multiple myeloma treatment, while panobinostat is typically reserved for later lines of therapy.

In clinical studies, panobinostat is often used in combination with bortezomib rather than as a replacement for it. This combination approach has shown better results than either medication alone in people with relapsed multiple myeloma.

The choice between these medications depends on your treatment history, how your cancer has responded to previous therapies, and your overall health status. Your doctor will consider factors like previous side effects, current symptoms, and the specific characteristics of your cancer when making treatment recommendations.