Vorinostat

Vorinostat is approved to treat cutaneous manifestations in patients with cutaneous T-cell lymphomaA cancer arising in the lymphatic system. The white blood cells affected are part of the body's immune system. The lymphatic system is a large network of vessels that carry fluid and cells of the immune system around the body. Lymph nodes are regional collection centers in the lymphatic system. See also, 'lymphatic system'. (CTCL) that is persistent or recurrent after two prior treatments. Treatment with vorinostat is a once daily oral capsule which is generally taken with food.1
Vorinostat (Zolinza®) is a histone deacetylase (HDAC) inhibitor. The anti-cancer mechanisms of vorinostat are not fully known, but it is believed that the HDAC inhibition opens chromatinA combination of DNA and proteins. Our chromosomes are composed of DNA that is twisted around proteins much like thread on a spool. to allow for geneA stretch of DNA that leads to the production of an RNA. The RNA is produced during the process of transcription. This RNA can be used to guide the formation of a protein via translation or can be used directly in the cell. transcriptionThe production of an RNA molecule from a DNA template. An RNA copy of a gene is produced by an enzyme, RNA polymerase. The RNA produced can either be used directly in the cell or can be used to direct the production of a protein through the process of translation. Many of the genes that are altered in cancer cells have potent effects on the process of transcription. See transcription factor. and inhibition of cell division. In cancer cells, HDACs are often overexpressed, creating a condensed chromatin structure that inhibits gene transcription, and in turn can lead to apoptosisAlso called programmed cell death. Apoptosis is a natural process that occurs throughout the lives of almost all animals and plants. The death of the cells is a carefully controlled process that does not generate any inflammation..1
The diagram below shows the 3D molecular structure of Vorinostat.
Side Effects include: Low platelet and red blood cell counts, Nausea, vomiting, anorexia, constipation and diarrhea, Hyperglycemia, Fatigue and chills, Taste disorders.1
Patients receiving anticoagulants should be closely monitored during vorinostat treatment due to the potential for increased prothrombin time and international normalized ratio (INR). Pulmonary embolism and deep vein thrombosis have also been observed in some cases. Use of vorinostat along with other HDAC inhibitors can produce decreased platelet counts and gastrointestinal bleeding. Women should avoid becoming pregnant during vorinostat treatment due to the possibility of developmental defects in the fetus. Women who are already pregnant should be warned of this risk. New mothers who decide to begin treatment with vorinostat should discontinue nursing. Since vorinostat is eliminated via metabolismThe sum of all reactions in a cell or animal. Processes that lead to the creation of biomolecules such as proteins and nucleic acids are termed anabolic pathways. Processes in which biomolecules are broken down, such as the digestion of foods, are termed catabolic. Metabolism is a term that encompasses both sets of processes. by the liver, patients with liver failure should be treated with caution.1