Vorinostat

Vorinostat, also known as suberoylanilide hydroxamic acid (SAHA), is a small-molecule medication that acts as a histone deacetylase (HDAC) inhibitor. By inhibiting class I and II HDACs, vorinostat increases acetylation of histones and other proteins, leading to changes in gene expression that can promote cell cycle arrest, differentiation, and apoptosis in malignant cells.

In the United States, vorinostat was approved by the Food and Drug Administration in 2006 for the treatment of cutaneous T-cell lymphoma (CTCL) in patients with disease that is persistent, progressive, or recurrent after at least one prior systemic therapy. It is marketed under the brand name Zolinza. The drug is used as monotherapy and is typically administered orally.

Administration and dosing are determined by the treating clinician. Vorinostat is taken by mouth, usually once daily, and may be given with or without food. The dose is adjusted based on tolerance and blood counts, particularly because of hematologic effects.

Common adverse effects associated with vorinostat include fatigue, diarrhea, nausea, vomiting, anorexia, weight loss, edema, thrombocytopenia, anemia, and neutropenia. Other reported effects can include abdominal pain, headache, dehydration, and elevated liver enzymes. Serious hematologic and hepatic toxicity require regular monitoring, and dose modifications may be necessary if laboratory abnormalities occur.

Research into vorinostat has explored its use in other hematologic and solid tumors and in combination regimens, though its approved indication remains CTCL. As with other HDAC inhibitors, patient selection and monitoring are important to balance potential benefits with risks.