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Library · Immune · Treatment of T-cell lymphomas

Romidepsin

FK228, FR901228, Istodax, Depsipeptide

An HDAC inhibitor, marketed as Istodax, approved by the FDA for cutaneous T-cell lymphoma after at least one prior systemic therapy. It alters gene expression tied to cell-cycle arrest and death, killing cancer cells.

Research score 85/100. Reference only, not a dose.

Boxed warning: Risk of major cardiovascular events

  • Anti-cancer
  • Immune Boosting
  • Anti-inflammatory
  • DNA Repair
  • Hormone Regulation
US status
FDA Approved
Approval
FDA Approved
Evidence
FDA approved for CTCL. PTCL indication withdrawn in 2021.
Research score
85 / 100
Indication
Multiple Approved Indications
Origin
Japan
Source category
Immune System
Status group
Approved / prescription

Mechanism

After cellular uptake, a released thiol group chelates zinc in the HDAC active site, raising histone acetylation to boost tumor-suppressor and cell-cycle genes; this triggers p21-driven cell-cycle arrest, apoptosis via death receptors, disrupted DNA repair, and enhanced immune recognition of tumor cells.

Safety file

Can cause blood-cell toxicity, GI issues, and fatigue; serious infections are possible; ECG T-wave changes can occur.

  • Nausea
  • Fatigue
  • Infections
  • Thrombocytopenia
  • Neutropenia
  • ECG changes
  • Electrolyte abnormalities