Treatment Name: Romidepsin (Istodax®)
Romidepsin (Istodax®) is a Chemotherapy Regimen for Lymphoma, T-Cell
How does romidepsin work?
Romidepsin is designed to either kill cancer cells, or slow growth of cancer cells by helping activate anti-cancer genes that have been turned off.
Goals of therapy:
Romidepsin is given to shrink tumors and decrease symptoms of T-cell lymphoma. Romidepsin is not commonly given with the goal of cure.
- Romidepsin intravenous infusion is given over four hours on Days 1, 8, and 15
- No treatment is given on Day 22
Romidepsin is usually given in an outpatient infusion center, allowing the person to go home afterwards. On occasion, romidepsin may be given in the hospital if someone is too sick.
Romidepsin is repeated every 28 days. This is known as one cycle. Each cycle is repeated until the drug stops working or when intolerable side effects occur.
Click here for common starting doses.
In clinical studies, the most commonly reported side effects with romidepsin are shown here. Side effects sometimes have percentage ranges [example 51 – 54%] because they differed between in clinical studies:
- Nausea (51 - 54%)
- Fatigue or muscle weakness (41 - 52%)
- Increased bleeding risk [low platelets] (40 - 47%)
- Low white blood cells (29 - 49%)
- Anemia [low red blood cells] (21 - 40%)
- Vomiting (19 - 34%)
- Fever (17 - 20%)
- Diarrhea (11 - 23%)
- Headache (11 - 17%)
- Constipation (8 - 15%)
- Altered taste (6 - 21%)
- Infections (6 - 18%)
- Stomach pain (6%)
- Upset stomach (5%)
- Trouble breathing (5%)
- Weight loss (8%)
- Mouth sores (7%)
- Fast heart beat (5%)
- Chills (5%)
- Water retention (2%)
Approximately 10% of patients discontinue romidepsin due to unacceptable side effects
How often is monitoring needed?
Labs (blood tests) may be checked before treatment and before each dose of romidepsin. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), blood potassium, blood magnesium, plus any you doctor may order.
How often is imaging needed?
Imaging may be checked before treatment and periodically during treatment to check for side effects and to see how you are responding to therapy. Imaging may include: electrocardiogram (ECG also known as "EKG"), computed tomography (CT) scan, or positron emission tomography (PET) scan.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue romidepsin as planned, or delay or switch therapy.
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for T-cell lymphoma. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Romidepsin (Istodax®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Romidepsin (Istodax®). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Romidepsin (Istodax®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Romidepsin (Istodax®)