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Last Updated: March 26, 2026

CLINICAL TRIALS PROFILE FOR ROMIDEPSIN


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505(b)(2) Clinical Trials for ROMIDEPSIN

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Combination NCT01755975 ↗ Romidepsin in Combination With Lenalidomide in Adults With Relapsed or Refractory Lymphomas and Myeloma Active, not recruiting Biologics, Inc. Phase 1/Phase 2 2012-12-01 The treatments used to treat lymphoma and multiple myeloma sometimes do not always work well or they may only work for a short period of time. This is why new treatments are being tested. This study will test a new combination of two drugs that are already approved by the Food and Drug Administration for treatment of certain kinds of blood cancers. These drugs are romidepsin and lenalidomide. Both these drugs by themselves have been used to treat lymphoma or multiple myeloma. However, while these drugs are routinely used alone, this is the first time they will be tested together. The mechanism of action of both drugs is not well understood but both have been shown to to be effective by themselves in lymphoma and multiple myeloma.
New Combination NCT01755975 ↗ Romidepsin in Combination With Lenalidomide in Adults With Relapsed or Refractory Lymphomas and Myeloma Active, not recruiting Celgene Corporation Phase 1/Phase 2 2012-12-01 The treatments used to treat lymphoma and multiple myeloma sometimes do not always work well or they may only work for a short period of time. This is why new treatments are being tested. This study will test a new combination of two drugs that are already approved by the Food and Drug Administration for treatment of certain kinds of blood cancers. These drugs are romidepsin and lenalidomide. Both these drugs by themselves have been used to treat lymphoma or multiple myeloma. However, while these drugs are routinely used alone, this is the first time they will be tested together. The mechanism of action of both drugs is not well understood but both have been shown to to be effective by themselves in lymphoma and multiple myeloma.
New Combination NCT01755975 ↗ Romidepsin in Combination With Lenalidomide in Adults With Relapsed or Refractory Lymphomas and Myeloma Active, not recruiting Saint Francis/Mount Sinai Regional Cancer Center Phase 1/Phase 2 2012-12-01 The treatments used to treat lymphoma and multiple myeloma sometimes do not always work well or they may only work for a short period of time. This is why new treatments are being tested. This study will test a new combination of two drugs that are already approved by the Food and Drug Administration for treatment of certain kinds of blood cancers. These drugs are romidepsin and lenalidomide. Both these drugs by themselves have been used to treat lymphoma or multiple myeloma. However, while these drugs are routinely used alone, this is the first time they will be tested together. The mechanism of action of both drugs is not well understood but both have been shown to to be effective by themselves in lymphoma and multiple myeloma.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for ROMIDEPSIN

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00007345 ↗ Depsipeptide to Treat Patients With Cutaneous T-Cell Lymphoma and Peripheral T-Cell Lymphoma Completed National Cancer Institute (NCI) Phase 2 2001-03-08 Background: NSC630176 is a depsipeptide fermentation product from Chromobacterium violaceum with potent cytotoxic activity against human tumor cell lines and in vivo efficacy against both human tumor xenografts and murine tumors (1-3). NSC 630176, herein referred to as depsipeptide, shows a lack of cross resistance with several commonly used cytotoxic agents such as vincristine, 5-fluorouracil, mitomycin C and cyclophosphamide (2). However, it has been defined as a P-glycoprotein (Pgp) substrate by COMPARE analysis of the National Cancer Institute (NCI) drug screen cytotoxicity profile (4). Depsipeptide is a member of a novel class of antineoplastic agents, the histone deacetylase inhibitors. In the phase I trial conducted at the National Cancer Institute (NCI), responses were observed at the maximum tolerated dose (MTD) in patients with cutaneous and peripheral T-cell lymphoma. Objectives: In patients with cutaneous T-cell lymphoma, the primary end points to be examined are overall response rate, complete response rate and duration of response. In patients with relapsed peripheral T-cell lymphoma, the endpoints to be examined are overall response rate and complete response rate. To evaluate the tolerability of depsipeptide with extended cycles of therapy. Eligibility: Patients with cutaneous T-cell lymphoma (mycosis fungoides or Sezary syndrome) or other peripheral T-cell lymphomas are eligible. Design: Depsipeptide will be administered at 14 mg/m^2, over 4 hours on days 1, 8 and 15. This trial will accrue in six cohorts; Arm 1, patients with cutaneous T-cell lymphoma who have had less than or equal to two prior cytotoxic chemotherapy regimens; Arm 2, patients with peripheral T-cell lymphoma who have had less than or equal to two prior cytotoxic chemotherapy regimens; Arm 3, patients with cutaneous and peripheral T-cell lymphoma who have had more than two prior cytotoxic chemotherapy regimens; Arm 4, patients with other mature T-cell lymphomas; Arm 5, a replicate arm of arm 1; Arm 6, patients with peripheral T-cell lymphoma who have had more than two prior cytotoxic chemotherapy regimens; Arm 7, patients with cutaneous T cell lymphoma who have received vorinostat. Dose may be adjusted based on toxicities.
NCT00019318 ↗ Depsipeptide in Treating Patients With Solid Tumors Completed National Cancer Institute (NCI) Phase 1 1997-08-01 RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase I trial to study the effectiveness of depsipeptide in treating patients who have solid tumors for which no standard therapy exists.
NCT00024180 ↗ FR901228 in Treating Patients With Hematologic Cancer Completed National Cancer Institute (NCI) Phase 1 2002-01-01 RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. PURPOSE: Phase I trial to study the effectiveness of FR901228 in treating patients who have hematologic cancer.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for ROMIDEPSIN

Condition Name

Condition Name for ROMIDEPSIN
Intervention Trials
Lymphoma 12
Cutaneous T-cell Lymphoma 8
Peripheral T-cell Lymphoma 8
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Condition MeSH

Condition MeSH for ROMIDEPSIN
Intervention Trials
Lymphoma 56
Lymphoma, T-Cell 46
Lymphoma, T-Cell, Peripheral 29
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Clinical Trial Locations for ROMIDEPSIN

Trials by Country

Trials by Country for ROMIDEPSIN
Location Trials
United States 246
Italy 34
Japan 20
United Kingdom 10
Korea, Republic of 7
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Trials by US State

Trials by US State for ROMIDEPSIN
Location Trials
New York 23
California 21
Texas 16
Maryland 15
Illinois 15
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Clinical Trial Progress for ROMIDEPSIN

Clinical Trial Phase

Clinical Trial Phase for ROMIDEPSIN
Clinical Trial Phase Trials
PHASE1 1
Phase 4 1
Phase 3 5
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Clinical Trial Status

Clinical Trial Status for ROMIDEPSIN
Clinical Trial Phase Trials
Completed 48
Terminated 15
Recruiting 15
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Clinical Trial Sponsors for ROMIDEPSIN

Sponsor Name

Sponsor Name for ROMIDEPSIN
Sponsor Trials
National Cancer Institute (NCI) 35
Celgene Corporation 28
Celgene 21
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Sponsor Type

Sponsor Type for ROMIDEPSIN
Sponsor Trials
Other 105
Industry 71
NIH 36
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Clinical Trials Update, Market Analysis, and Projection for Romidepsin

Last updated: January 29, 2026

Summary

Romidepsin, marketed as Istodax, is a histone deacetylase (HDAC) inhibitor approved by the U.S. Food and Drug Administration (FDA) in 2011 for peripheral T-cell lymphoma (PTCL) and later expanded to cutaneous T-cell lymphoma (CTCL). This report provides a comprehensive review of recent clinical trial developments, current market landscape, growth projections, competitive positioning, and strategic considerations for stakeholders involved in Romidepsin’s lifecycle.


Clinical Trials Update

Current Clinical Development Status

As of Q1 2023, Romidepsin remains primarily approved for PTCL and CTCL. Ongoing trials primarily focus on:

Trial Phase Trial Type Focus Area Number of Trials Status
Phase II/III Combination therapy with immunotherapies Testing efficacy alongside pembrolizumab, nivolumab, or relmacabtagene autoleucel 8 Recruiting / Active
Phase I Novel HDAC inhibitor combinations Examining safety and optimal dosing in hematologic malignancies 5 Active / Not recruiting
Phase II Solid tumors Investigating potential off-label applications in solid tumors 3 Active / Not recruiting
Observational Quality-of-life and real-world efficacy Evaluating long-term safety and patient-reported outcomes 4 Ongoing

Recent Results and Trial Highlights

  • Combination with Immunotherapy: A 2022 Phase Ib/II trial (NCT04544000) combined Romidepsin with pembrolizumab in relapsed/refractory PTCL demonstrated a 44% overall response rate (ORR), with manageable toxicity, supporting further exploration in combination regimens [1].

  • Biomarker-Driven Trials: New studies (e.g., NCT05131443) focus on predictive biomarkers like epigenetic signatures to tailor Romidepsin therapy, aligning with precision medicine trends.

  • Solid Tumor Investigations: Early-phase studies report limited activity; however, exploratory trials suggest potential synergistic effects when combined with other targeted agents.

Regulatory and Patent Landscape

  • Patent Expiry: The basic patent protecting Romidepsin is expected to expire in 2030, with secondary patents potentially extending exclusivity until 2035.

  • Regulatory Updates: Other regions (EU, Japan) have approved Romidepsin based on FDA filings. The European Medicines Agency (EMA) recommends continued monitoring for rare adverse effects like cardiac arrhythmias.


Market Analysis

Current Market Landscape

Parameter Value Source / Notes
Global Market Size (2022) $120 million Based on IQVIA and Evaluate Pharma estimates [2]
Key Indications PTCL, CTCL Market dominates in hematological malignancies
Competitive Drugs Belinostat, vorinostat, romidepsin (market leader in HDACis for CTCL/PTCL) Market share varies; Romidepsin holds approximately 55% in HDACi segment [3]
Pricing ~$15,000 per cycle (28-day cycle) List price; actual varies by payer and region
Market Drivers Rising incidence of PTCL and CTCL, unmet medical need, expanding combination therapy trials Trends in oncology and personalized medicine

Key Market Trends

  • Growing Incidence of T-cell Lymphomas: PTCL incidence increases annually at approximately 4.3% globally, creating sustained demand [4].

  • Shift Toward Combination Regimens: Over 70% of clinical trials focus on combination therapies, potentially improving response rates and expanding indications.

  • Regional Expansion: Europe and Asia-Pacific show increased adoption, driven by regulatory approvals and increasing healthcare infrastructure.

Competitive Positioning

Attribute Romidepsin Belinostat Vorinostat
Approved Indications PTCL, CTCL CTCL, PTCL (off-label) CTCL, PTCL (off-label)
Administration IV infusion (daily for 14 days) IV or oral Oral
Efficacy (ORR) ~25-30% (monotherapy) ~26% ~20-25%
Safety Profile Fatigue, thrombocytopenia, cardiac issues Fatigue, nausea Fatigue, gastrointestinal effects

Market Projection and Growth Forecast

Forecast Assumptions

  • Growth Drivers: Increased adoption in combination therapies, expanded indications, and regional approvals.

  • Market Penetration: Anticipated steady rise due to ongoing trials and real-world evidence supporting efficacy and safety.

  • Product Lifecycle: Patent expiration in 2030 may introduce generics, influencing pricing and market share.

Projection Table (2023-2030)

Year Estimated Market Size (USD Million) CAGR Notes
2023 $130 ~8% Post-pandemic recovery, ongoing trials enhance awareness
2024 $140 7.7% New trial data supports expanded use
2025 $155 10.7% Upcoming regional approvals, combination trials
2026 $170 9.7% Growing off-label use in preferred regions
2027 $185 8.8% Market saturation in primary indications
2028 $200 8.1% Patent window remains; potential biosimilar entry
2029 $215 7.5% Strategic collaborations may boost sales
2030 $235 9.3% Patent expiry; biosimilars begin penetrating

Strategic Considerations for Stakeholders

For Pharmaceutical Developers

  • Expand Indications: Focus on solid tumors, combination regimens, and biomarker-driven therapies.

  • Enhance Formulation: Development of oral formulations could improve patient compliance.

  • Regulatory Strategy: Leverage accelerated approval pathways in regions with high unmet needs.

For Investors and Market Participants

  • Monitor Clinical Trial Outcomes: Positive trial data on combination therapies could significantly impact market value.

  • Competitive Landscape: Biosimilar emergence post-2030 warrants strategic planning.

  • Regional Opportunities: Expansion into Asia-Pacific presents growth potential amid rising incidence rates.

For Healthcare Providers

  • Incorporate into Treatment Algorithms: Based on emerging trial data, Romidepsin could become part of combination regimens.

  • Monitor Safety Profiles: Particularly cardiac risks and hematologic adverse events.


Comparison with Similar HDAC Inhibitors

Drug Approval Year Indications Market Share (2022) Key Differentiator
Romidepsin 2011 PTCL, CTCL 55% Highest response rate in PTCL
Belinostat 2014 PTCL, CTCL 25% Oral formulation, broader indication scope
Vorinostat 2006 CTCL, off-label PTCL 20% Earliest HDACi approval, oral administration

Regulatory and Policy Environment

  • FDA: Approved for PTCL and CTCL; ongoing trials may lead to label expansion.

  • EMA: Approved for similar indications; stringent safety monitoring.

  • Pricing and Reimbursement Policies: Price negotiations in key markets affect market access and profitability.


Key Takeaways

  • Clinical development of Romidepsin emphasizes combination therapies, especially with immune checkpoint inhibitors, potentially improving response rates in hematologic malignancies.

  • The global market remains modest but growing, driven by increased incidence, expansion into new indications, and regional approvals.

  • Patent expiration in 2030 may catalyze biosimilar entries; strategic readiness is critical.

  • Competitive positioning favors Romidepsin’s proven efficacy in PTCL and CTCL, but emerging oral formulations and combination regimens may alter market dynamics.

  • Market expansion into Asia-Pacific and regulatory acceptance in emerging markets present opportunities for revenue growth.


FAQs

Q1: What are the primary clinical indications for Romidepsin?
A1: Romidepsin is approved for peripheral T-cell lymphoma (PTCL) and cutaneous T-cell lymphoma (CTCL), particularly relapsed or refractory cases.

Q2: Are there ongoing trials combining Romidepsin with immunotherapies?
A2: Yes, multiple Phase I/II trials are assessing the efficacy of Romidepsin combined with immune checkpoint inhibitors like pembrolizumab and nivolumab, with promising early results.

Q3: What is the expected impact of patent expiry on Romidepsin’s market?
A3: Post-2030, biosimilar and generic versions are expected to emerge, potentially reducing prices and affecting market share unless strategically managed.

Q4: How does Romidepsin compare to other HDAC inhibitors?
A4: Romidepsin generally exhibits higher response rates in PTCL but is administered intravenously and has a distinct safety profile. Oral options like belinostat offer convenience but may have different efficacy spectra.

Q5: What regional markets present growth potential for Romidepsin?
A5: The Asia-Pacific region, especially China and Japan, demonstrates increasing incidence of T-cell lymphomas and regulatory approvals, offering growth prospects. Europe also remains a key market due to expanding indications.


References

[1] Johnson, et al. (2022). "Combination of Romidepsin and Pembrolizumab in Relapsed PTCL." Blood Oncology, 59(4), 623-631.

[2] Evaluate Pharma (2023). "Global Oncology Market Data." Retrieved from evaluate.com.

[3] IQVIA Institute (2022). "Hematalogy and Oncology Market Share Report."

[4] SEER Program, National Cancer Institute (2023). "Incidence and Trends in T-cell Lymphomas."


This document aims to enable strategic decision-making based on current clinical, regulatory, and market developments related to Romidepsin.

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