Efficacy and tolerability of the histone deacetylase inhibitor panobinostat in clinical practice

The histone deacetylase inhibitor panobinostat has shown efficacy in phase‐II and phase‐III trials for multiple myeloma and has recently received market approval in combination with bortezomib and dexamethasone. Here, we retrospectively report our single center experience with panobinostat/bortezomib/dexamethasone (FVD) in a heavily pretreated patient population (n = 24) with a high degree of refractoriness to proteasome inhibitors (PI) and immunomodulatory drugs (IMiD). Median age was 67 years (range 49‐87) and the median number of prior therapies was 5 (range 2‐17). Fourteen patients (58%) had high‐risk cytogenetic aberrations. Thirteen (54%) and 21 (88%) patients were refractory to PIs and IMiDs, respectively. Twelve patients (50%) were refractory to bortezomib and 7 (29%) to carfilzomib; 6 patients (25%) were refractory to both bortezomib and carfilzomib. In 21 patients evaluable for response, overall response rate (ORR; ≥PR) was 33% (7/21) and 81% (17/21) achieved at least stable disease. Median progression‐free survival (PFS) and overall survival were 3.5 and 9.8 months, respectively. Significant differences between bortezomib‐sensitive and ‐refractory patients were observed. In bortezomib‐sensitive patients, median PFS was 6.3 months compared to 2.3 months in bortezomib‐refractory patients (P