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Pronunciation | /vɒˈrɪnoʊstæt/ vorr-IN-oh-stat |
Trade names | Zolinza |
AHFS/Drugs.com | Monograph |
MedlinePlus | a607050 |
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Routes of administration | Oral (capsules) |
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Pharmacokinetic data | |
Bioavailability | 1.8–11%[1] |
Protein binding | ~71% |
Metabolism | Hepatic glucuronidation and β-oxidation CYP system not involved |
Metabolites | vorinostat O-glucuronide, 4-anilino-4-oxobutanoic acid (both inactive)[2] |
Elimination half-life | ~2 hours (vorinostat and O-glucuronide), 11 hours (4-anilino-4-oxobutanoic acid) |
Excretion | Renal (negligible) |
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ECHA InfoCard | 100.207.822 |
Chemical and physical data | |
Formula | C14H20N2O3 |
Molar mass | 264.325 g·mol−1 |
3D model (JSmol) | |
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Vorinostat (rINN)[3] also known as Suberoylanilide hydroxamic acid (suberoyl+anilide+hydroxamic acid abbreviated as SAHA) is a member of a larger class of compounds that inhibit histone deacetylases (HDAC). Histone deacetylase inhibitors (HDI) have a broad spectrum of epigenetic activities.
Vorinostat is marketed under the name Zolinza (/zoʊˈlɪnzə/ zoh-LIN-zə) by Merck for the treatment of cutaneous manifestations in patients with cutaneous T cell lymphoma (CTCL) when the disease persists, gets worse, or comes back during or after two systemic therapies.[2][4] The compound was developed by Columbia University chemist Ronald Breslow and Memorial Sloan-Kettering researcher Paul Marks[5][6]
Vorinostat was the first histone deacetylase inhibitor[7] approved by the U.S. Food and Drug Administration (FDA) for the treatment of CTCL on October 6, 2006.[8] It also failed to demonstrate efficacy in treating acute myeloid leukemia in a phase II study.[9]
Vorinostat has been shown to bind to the active site of histone deacetylases and act as a chelator for zinc ions also found in the active site of histone deacetylases.[10] Vorinostat's inhibition of histone deacetylases results in the accumulation of acetylated histones and acetylated proteins, including transcription factors crucial for the expression of genes needed to induce cell differentiation.[10] It acts on class I, II and IV of histone deacetylase.
Vorinostat has also been used to treat Sézary syndrome, another type of lymphoma closely related to CTCL.[11]
A recent study suggested that vorinostat also possesses some activity against recurrent glioblastoma multiforme, resulting in a median overall survival of 5.7 months (compared to 4–4.4 months in earlier studies).[12] Further brain tumor trials are planned in which vorinostat will be combined with other drugs.
Including vorinostat in treatment of advanced non-small-cell lung carcinoma (NSCLC) showed improved response rates and increased median progression free survival and overall survival.[13]
It has given encouraging results in a phase II trial[14] for myelodysplastic syndromes in combination with idarubicin and cytarabine.[15]
Vorinostat is being investigated as a potential HIV latency reversing agent (LRA) as part of an investigational therapeutic strategy known as "shock and kill."[16] Vorinostat was shown to reactivate HIV in latently HIV-infected T cells, both in vitro and in vivo.[17][18]
Vorinostat also has shown some activity against the pathophysiological changes in α1-antitrypsin deficiency[19] and cystic fibrosis.[20] Recent evidence also suggests vorinostat can be a therapeutic tool for Niemann-Pick type C1 (NPC1), a rare lysosomal lipid storage disease.[21]
Preclinical experiments by University of Alabama at Birmingham researchers suggest the cancer drugs vorinostat, belinostat and panobinostat might be repurposed to treat infections caused by human papillomavirus, or HPV.[22]