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Concomitant Use of Panobinostat and Reirradiation in Progressive DIPG: Report of 2 Cases

Wang, Zhihong J. MD, PhD*; Ge, Yubin PhD; Altinok, Deniz MD; Poulik, Janet MD§; Sood, Sandeep MD; Taub, Jeffrey W. MD*; Edwards, Holly BS; Kieran, Mark W. MD, PhD; Steven, Miller MD#

Journal of Pediatric Hematology/Oncology: August 2017 - Volume 39 - Issue 6 - p e332–e335
doi: 10.1097/MPH.0000000000000806
Online Articles: Clinical and Laboratory Observations

Diffuse intrinsic pontine glioma (DIPG) remains a devastating disease. Panobinostat has been shown to have therapeutic efficacy both in vitro and in DIPG orthotopic xenograft models; however, clinical data in patients with DIPG are lacking. We present 2 cases of DIPG, who were treated with panobinostat at 22 to 25 mg/m2/dose, 3 times weekly for 2 weeks in 3-week cycles and concomitant reirradiation after disease progression. Two episodes of asymptomatic thrombocytopenia were observed in 1 patient. Hyperacetylation of histone H4 of peripheral blood mononuclear cells was evident following treatment. In our experience, panobinostat administered with reirradiation was well tolerated at a relatively higher dose than that used in adult studies.

Departments of *Pediatrics, Division of Pediatric Hematology Oncology

Oncology, Molecular Therapeutics Program

Radiology

§Pathology

Neurosurgery, Children’s Hospital of Michigan

#Radiation Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI

Dana-Farber Boston Children’s Cancer and Blood Disorders Center, Boston, MA

The authors declare no conflict of interest.

Reprints: Zhihong J. Wang, MD, PhD, Department of Pediatrics, Division of Pediatric Hematology Oncology, Children’s Hospital of Michigan, 3901 Beaubien Street, Detroit, MI 48201 (e-mail: jwang2@med.wayne.edu).

Received July 24, 2016

Accepted January 26, 2017

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