Epigenetic drugs
Epigenetic drugs act to regulate the production of proteins in cells by switching genes ‘on’ or ‘off’. HDAC inhibitors are one such class of drug, which act by interfering with the way histones (DNA packaging proteins) bind to DNA in cells. Panobinostat (Farydak®) is the only licensed HDAC inhibitor in the UK for myeloma patients and its mechanism of action is described in Module 5.
Another class of epigenetic drugs now being investigated for myeloma are the bromodomain inhibitors. Inobrodib (also known as CCS1477) is a drug in early phase clinical trials and its mechanism of action is to prevent the recruitment of critical proteins required for gene transcription in myeloma cells. This downregulates the production of proteins necessary for myeloma cell survival.