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 a chemotherapy drug given to shrink tumors and decrease symptoms of T-cell lymphoma. Romidepsin is not commonly given with the goal of cure.
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. Drug side effects sometimes have percentage ranges [example 51 – 54%] because they differed between clinical studies:
Approximately 10% of patients discontinue romidepsin due to unacceptable side effects.
Nausea and Vomiting
Fatigue 
Anemia
Diarrhea
Constipation
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.
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.
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.
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®)
DiarrheaFatigue ConstipationAnemia1. Coiffier B, Pro B, Prince HM, et al. Results from a pivotal, open-label, phase II study of romidepsin in relapsed or refractory peripheral T-cell lymphoma after prior systemic therapy. J Clin Oncol. 2012;30:631-636.
2. Piekarz RL, Frye R, Prince HM, et al. Phase 2 trial of romidepsin in patients with peripheral T-cell lymphoma. Blood. 2011;117:5827-5834.
Created: November 8, 2015 Updated: September 22, 2018
A disease of lymphocytes called T-lymphocytes, or "T-cells" that are found most commonly in the skin, spleen, blood, bone marrow, and/or lymph nodes. Peripheral T-cell lymphoma (PTCL) and cutaneous T-cell lymphoma (CTCL) are the two main types of T-cell lymphoma; however, there are many different subtypes of PTCL and CTCL and all are very rare.
The exact cause of T-cell lymphomas is not known, but certain viral infections such as the Epstein-Barr Virus (EBV) and human T-cell leukemia virus have been associated with development of T-cell lymphomas. The stage of T-cell lymphoma can vary at diagnosis and throughout treatment. Stages of T-cell lymphoma include stage I, II, III, and IV. The effectiveness of the treatment may depend upon the stage and specific subtype at diagnosis.
If you are interested in reading the clinical trials results, please click on references below:
1. Coiffier B, Pro B, Prince HM, et al. Results from a pivotal, open-label, phase II study of romidepsin in relapsed or refractory peripheral T-cell lymphoma after prior systemic therapy. J Clin Oncol. 2012;30:631-636.
2. Piekarz RL, Frye R, Prince HM, et al. Phase 2 trial of romidepsin in patients with peripheral T-cell lymphoma. Blood. 2011;117:5827-5834.
A Complete Blood Count (CBC) is a frequently ordered blood test that tells clinicians the status of your: 1) White blood cell count, 2) Hemoglobin, and 3) Platelet count at the time the test was taken.
Common uses:
1) White blood cell count (WBC): is used to determine infection risk, or response to chemotherapy. Certain chemotherapy agents may harm our good infection-fighting cells. Sometimes chemotherapy may need to be delayed to allow these cells to recover.
2) Hemoglobin: is used to determine if someone is anemic. Anytime the hemoglobin is below 12 g/dL, the person is said to be anemic. Red blood cell transfusions, and sometimes iron can be given to restore the hemoglobin level, but anemia treatment should always aim at treating the underlying cause or condition.
3) Platelet count: is used to determine if the risk of bleeding is increased or if a platelet transfusion is required to prevent bleeding. Certain medications that increase bleeding risk, such as: aspirin, certain chemotherapy agents, and blood thinners, may need to be stopped temporarily until the platelet count is within a safe range.
A Comprehensive Metabolic Panel (CMP) is a frequently ordered blood test that tells clinicians the status of your: 1) Electrolytes & Acid/Base status, 2) Kidney function, 3) Liver function, 4) Blood sugar, and 5) Calcium at the time the test was taken. It is commonly used to monitor liver and kidney function when beginning new medications such as chemotherapy. A total of 14 tests are run simultaneously and are shown below.
Electrolytes & Acid/Base status:
1) Sodium, 2) Potassium, 3) Carbon dioxide, 4) Chloride
Kidney Function:
5) BUN (blood urea nitrogen), 6) Serum creatinine (Scr)
Liver Function:
7) AST, 8) ALT, 9) Total bilirubin, 10) Alk Phos, 11) Albumin, 12) Total protein
Blood sugar:
13) Serum glucose
Calcium:
14) Serum calcium