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LBH589

Phase 2

Diffuse Large B Cell Lymphoma | Small molecule | Oncology |Novartis AG|Last Updated: Mar 24, 2023

Success Probability

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Trial Design

RandomizedCONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment42

FDA Designations

No designations recorded

Clinical trial landscape

LBH589 · 18 trials · 23 indications

Phase 2 4Phase 1 14
NCT00936611LBH589 in Relapsed or Relapsed and Refractory Waldenstrom's MacroglobulinemiaWaldenstrom's Macroglobulinemia
COMPLETED39 Analytics
NCT02290431Study of Panobinostat in Combination With Bortezomib and Dexamethasone in Japanese Patients With Relapsed/Refractory Multiple MyelomaRelapse/Refractory Multiple Myeloma
COMPLETED31 Analytics
NCT01238692A Phase II Study of Oral Panobinostat (LBH589) and Rituximab to Treat Diffuse Large B Cell Lymphoma (DLBCL)Diffuse Large B Cell Lymphoma
COMPLETED42 Analytics
NCT00550277LBH589 Treatment for Refractory Clear Cell Renal CarcinomaRenal Cell Carcinoma
COMPLETED20 Analytics
PHASE2COMPLETED
LBH589 in Relapsed or Relapsed and Refractory Waldenstrom's Macroglobulinemia
Waldenstrom's MacroglobulinemiaUnlock trial analytics
PHASE2COMPLETED
Study of Panobinostat in Combination With Bortezomib and Dexamethasone in Japanese Patients With Relapsed/Refractory Multiple Myeloma
Relapse/Refractory Multiple MyelomaUnlock trial analytics
PHASE2COMPLETED
A Phase II Study of Oral Panobinostat (LBH589) and Rituximab to Treat Diffuse Large B Cell Lymphoma (DLBCL)
Diffuse Large B Cell LymphomaUnlock trial analytics
PHASE2COMPLETED
LBH589 Treatment for Refractory Clear Cell Renal Carcinoma
Renal Cell CarcinomaUnlock trial analytics

Study Endpoints

Primary Endpoints

Overall Response Rate
Assessed after 2nd cycle and then every subsequent cycle for 6 cycles. The median number of completed cycles of therapy was 5 (0- 32). As such observed up to ~32 months.

Overall response rate is percentage of participants with complete (CR), very good partial (VGPR), partial (PR), or minimal response (MR) as best response during treatment. CR * Disappearance of monoclonal protein by immunofixation * No histologic evidence of bone marrow involvement * Resolution of any adenopathy/organomegaly (confirmed by CT scan), or signs or symptoms attributable to WM. * Second immunofixation required for confirmation. VGPR -At least 90% reduction of serum monoclonal IgM concentration on protein electrophoresis. PR * At least 50% reduction of serum monoclonal IgM concentration on protein electrophoresis and at least 50% decrease in adenopathy/organomegaly on physical examination or on CT scan. * No new symptoms or signs of active disease. MR * At least 25% but less than 50% reduction of serum monoclonal IgM by protein electrophoresis. * No new symptoms or signs of active disease.

Percentage of Participants With Near Complete Response (nCR)/ Complete Response (CR) Rate
after 24 weeks (8 cycles; cycle = 21 days)

nCR plus CR rate after 8 cycles of therapy as defined by the modified European Society for Bone and Marrow Transplantation (EBMT) criteria per investigator assessment as the proportion of participants with nCR or CR as their best overall response.

Efficacy of LBH589 alone and when given in combination with rituximab
2 years
Progression-free Survival
18 months

Progression-free survival was defined as the interval from the date of first treatment with panobinostat until the date that disease progression or death occurred. Progressive disease (PD): 20% increase in the sum of diameters of target measurable lesions above the smallest sum observed (over baseline if no decrease in the sum is observed during therapy), with a minimum absolute increase of 5 mm.

To obtain an early evaluation of efficacy by response rate using RECIST criteria.
2 years
To Determine the Maximum Tolerated Doses (MTD) and Dose-limiting Toxicities (DLT) of LBH589 in Combination With Capecitabine When Administered to Patients With Refractory and Advanced Tumor Types That Are Sensitive to 5-fluorouracil
18 months

MTD for Capecitabine, BID

To assess the effect of various degrees of impairment in hepatic function as measured by the National Cancer Institute-Cancer Therapy Evaluation Program (NCI-CTEP) criteria, on the pharmacokinetics of panobinostat.
first 7 days
Determine the maximum tolerated dose of oral panobinostat in combination with trastuzumab and paclitaxel. Determine the maximum tolerated dose of iv LBH in combination with trastuzumab and paclitaxel.
At least 21 day cycle for both arms
To characterize the safety and tolerability of LBH589, including acute and chronic toxicities in Japanese patients with advanced solid tumors.
First cycle
To determine the highest and safest dose of LBH589 when it is administered in combination with lenalidomide & dexamethasone
24 weeks
To determine the MTD of i.v. LBH589 in combination with docetaxel and prednisone in patients with HRPC
determine if MTD occurs after every 3 - 6 pts
Pharmacokinetic (PK) parameters
first 10 days
Levels of LBH589 in the blood
every week for the first 3 weeks
To determine the MTD of panobinostat with bortezomib
throughout the study
Levels of LBH589 in the blood on days 1, 5, 8, 9 and 10 of first cycle
2 weeks
Rates and routes of excretion of LBH589 and its metabolites in urine and feces following administration of a single oral dose of [14C] LBH589
during the first 8 days on study

oral dose of \[14C\] LBH589

To determine the maximum-tolerated dose of LBH589
1st cycle
Number of Participants DLT in Arm 1 in Dose Escalation Phase
Cycle 1 (28-day treatment cycle)

Maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) for consecutive dosing schedule (MWF weekly). A 3-parameter version of a Bayesian logistic regression model with overdose control (Babb, Rogatko, and Zacks 1998) was used during the dose escalation phase for dose level selection and determination of the MTD.

Number of Participants DLT in Arm 2 in Dose Escalation Phase
Cycle 1 (28-day treamtent cycle)

Maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) for intermittent dosing schedule (MWF weekly). A 3-parameter version of a Bayesian logistic regression model with overdose control (Babb, Rogatko, and Zacks 1998) was used during the dose escalation phase for dose level selection and determination of the MTD.

Secondary Endpoints

Median Progression Free Survival
Assessed after 2nd cycle and then every subsequent cycle for 6 cycles and then every 3 months. If taken off treatment at cycle 2 for disease progression, assessed every 3 months. The median (range) follow up from treatment start is 7.7 month (0.9 - 29.7).
Median Time to Progression
Assessed after 2nd cycle and then every subsequent cycle for 6 cycles and then every 3 months. If taken off treatment at cycle 2 for disease progression, assessed every 3 months. The median (range) follow up from treatment start is 7.7 month (0.9 - 29.7).
Median Duration of Response
Assessed after 2nd cycle and then every subsequent cycle for 6 cycles and then every 3 months. If taken off treatment at cycle 2 for disease progression, assessed every 3 months. The median (range) follow up from treatment start is 7.7 month (0.9 - 29.7).
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
LBH589EXPERIMENTAL30 mg three days a week (Mondays, Wednesdays and Fridays). 1 cycle was 28 days Dose modifications for attributable toxicities allowed for reduction to: * 25 mg, 20 mg three times a week every week * Or 20 mg three times a week every other week. No dose re-escalation was allowed. * The protocol was amended on 6/15/2010 because of concerns of toxicity to allow a starting dose of 25 mg; 12/36 (33%) patients were enrolled on the 25 mg dose.
LBH589 + bortezomib + dexamethasoneEXPERIMENTALParticipants were administered LBH589 (panobinostat)in combination with bortezomib and dexamethasone 2 weeks on/1 week off.
LBH589 plus RituximabEXPERIMENTAL -
TreatmentOTHERLBH589 will be administered orally at a dose of 45 mg (1 - 5 mg capsule and 2 - 20 mg capsules) on Monday and Thursday of each week (twice weekly). To enable patients to undergo cardiac monitoring, all patients must begin treatment on a Monday, and continue Monday/Thursday dosing during subsequent treatment cycles. Patients with objective response or stable disease after re-evaluation at week 8 will continue LBH589 at the same dose until disease progression, unacceptable toxicity and/or at the discretion of the investigator.
LBH589 with CapecitabineEXPERIMENTALMTD, LBH589 with Capecitabine
LBH589 and LapatinibEXPERIMENTALLBH589 and Lapatinib
LBH589, Capecitabine and LapatinibEXPERIMENTALLBH589, Capecitabine and Lapatinib (Breast Cancer Patients)
HDACiEXPERIMENTAL -
IV LBH589 + trastuzumab + paclitaxelEXPERIMENTALi.v. panobinostat
Oral LBH589 + trastuzumab + paclitaxelEXPERIMENTALoral panobinostat
LBH589 (Panobinostat)EXPERIMENTAL -
PAN 5 mgEXPERIMENTALPanobinostat 5 mg
PAN 10 mgEXPERIMENTALPanobinostat 10 mg
PAN 20 mgEXPERIMENTALPanobinostat 20 mg
PAN 25 mgEXPERIMENTALPanobinostat 25 mg
Panobinostat (LBH589)EXPERIMENTAL -
Arm 1, Group XEXPERIMENTAL -
Arm 1, Group YEXPERIMENTAL -
Arm 2, Group XEXPERIMENTAL -
Arm 2, Group YEXPERIMENTALPanobinostat was administered orally, once-a-day, on Monday-Wednesday-Friday (MWF), every other week, as part of a 28-day treatment cycle. Group Y is a sub-arm, based on disease indication.

Interventions

NameTypeDescription
LBH589DRUG -
LBH589 (panobinostat)DRUGPanobinostat (PAN) capsules were supplied at dose strengths of 10 mg and 15 mg. and dosed at 20mg during treatment phase 1 (21 days) and treatment phase 2 (42 days)
bortezomibDRUGBortezomib (BTZ) s.c: 1.3 mg/m2 was administered during both treatment phase 1 (21 days) \& treatment phase 2 (42 days).
dexamethasoneDRUGDexamethasone (Dex): 20mg tablets taken during both treatment phase 1 (21 days \& treatment phase 2 (42 days)
RituximabDRUGPatients randomized to Arm B will receive IV rituximab at a dose of 375 mg/m2 in combination with oral LBH589. Rituximab should be administered on the same day as LBH589, after the patient has taken their LBH589 dose. The appropriate amount of solution should be withdrawn from the vial for the following calculation: Volume (mL) = BSA (m2) × dose (375 mg/m2) / concentration of reconstituted solution ml/mL (100 mg/10 mL and/or 500 mg/50 mL).
CapecitabineDRUGCapecitabine will be administered orally twice daily for 14 days out of every 21 days.
LapatinibDRUGLapatinib, 1000 mg PO daily will be added to this combination.
IV LBH589DRUG -
Oral LBH589DRUG -
trastuzumabDRUG -
paclitaxelDRUG -
LenalidomideCOMBINATION_PRODUCTLenalidomide 5mg or 25 mg
LBH589 (i.v. panobinostat)DRUGi.v. LBH589 dose levels: 10, 15, or 20 mg/m2 i.v. docetaxel 75 or 60 mg/m2 oral prednisone 5mg bid. LBH589 i.v. administered on days 1 and 8 in combination with docetaxel i.v. on day 1 and prednisone p.o 5mg bid every day of a 21-day cycle
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites2

Inclusion Criteria: * Male or female patients aged 18 years or older * Must have received prior therapy for their WM, any number of prior therapies is allowed * Must have symptomatic relapsed or refractory WM * Measurable monoclonal IgM protein in the blood and presence of lymphoplasmacytic cells i...

Countries:United StatesJapanCanadaNetherlandsSwedenSwitzerlandUnited KingdomAustraliaBelgiumItalyFranceSpainGermany
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Frequently asked questions about LBH589

What is LBH589 used for?

LBH589 is an investigational small molecule being studied for the treatment of multiple cancers, including renal cell carcinoma, breast cancer, prostate cancer, diffuse large B cell lymphoma, and Waldenstrom's macroglobulinemia. It has also been evaluated in patients with advanced solid tumors and certain hematological malignancies.

Who makes LBH589?

LBH589 is being developed by Novartis AG, a multinational pharmaceutical company traded on the New York Stock Exchange under the ticker symbol NVS. The drug is an oncology small molecule that has been investigated in clinical trials for various tumor types.

What phase is LBH589 in?

LBH589 has completed Phase 1 and Phase 2 clinical trials. The completed trials include two Phase 1 studies and two Phase 2 studies. The drug is not approved and remains investigational, with no active trials currently listed.

What clinical trials is LBH589 in?

LBH589 has been studied in four completed clinical trials. These include NCT00472368 and NCT00503451, both Phase 1 studies in advanced solid tumors, and NCT00550277 and NCT00936611, both Phase 2 studies in renal cell carcinoma and Waldenstrom's macroglobulinemia, respectively.

Is LBH589 the same as panobinostat?

LBH589 is also known as panobinostat, a histone deacetylase inhibitor. The drug has been investigated under the LBH589 designation in clinical trials for various cancers, including renal cell carcinoma and Waldenstrom's macroglobulinemia.