Generic name (brand)

 

Mechanism of action

 

Uses

Dosage/route of administration

Azacitidine (Vidaza®) FDA approval 2004 DNMT inhibitor with possible cytotoxic effect Labeled: myelodysplastic syndrome (MDS) Unlabeled: Acute Myelogenous Leukemia (AML) MDS: 75 mg/m2/day x 7 days (subcutaneous, IV) Repeated every 4 week
Decitabine (Dacogen®) FDA approval 2006 DNMT inhibitor with possible cytotoxic effect Labeled: MDS Unlabeled: AML and Sickle Cell Anemia MDS: 15 mg/m2 every 8hrs (IV) (~45 mg/m2/day x 3 days). It is recommended to administer the drug for at least 4 cycles; continue until patient has no benefit
Vorinostat (Zolinza®) FDA approval 2006 Histone deacetylase (HDAC) inhibitor (class 1 and 2) Labeled: cutaneous T-cell lymphoma (CTCL) [progression, persistent & recurrent] CTCL: 400 mg orally once daily (until disease progresses or unacceptable toxicity develops)
Romidepsin (Istodax®) FDA approval 2009 HDAC inhibitor (potent class I inhibitor) Labeled: refractory CTCL and refractory Peripheral T-cell Lymphoma (PTCL) CTCL: 14 mg/m2 (IV) on days: 1, 8 and 15 in a 28-day cycle.
PTCL: 14 mg/m2 on days 1, 8, & 15 in a 28-day cycle.
(Repeat cycles as long as there is benefit & patient is tolerated)
Table 1: FDA approved epigenetic drugs and their labeled and unlabeled uses.