Romidepsin is a histone deacetylase inhibitor recently approved by the FDA for the treatment of cutaneous T-cell lymphoma. It has led to protracted responses in a significant subset of patients and provides a new treatment option for those refractory to first and second line systemic treatments. Given intravenously, its main toxicities are gastrointestinal as well as haematological. This review discusses the mechanism of action of romidepsin in cutaneous T-cell lymphoma (CTCL), and the clinical trials which provide the basis for FDA approval. We conclude by discussing practical aspects of its administration and give our opinion on how it should be incorporated into the therapeutic armamentarium for patients with refractory CTCL.
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