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Vorinostat + melphalan + prednisone (ZMP) is a combination regimen investigated for the treatment of relapsed or refractory multiple myeloma. Vorinostat (Zolinza) is a small molecule inhibitor of Class I and II histone deacetylases (HDAC), which induces cell cycle arrest and apoptosis in malignant cells. Melphalan is a nitrogen mustard alkylating agent that causes DNA cross-linking, and prednisone is a synthetic corticosteroid with anti-inflammatory and immunosuppressive properties. This specific combination was evaluated in a Phase I/II clinical trial (NCT00857324) led by Tiziana Marangon at the University of Turin to determine if the synergistic effects of HDAC inhibition could enhance the efficacy of the standard melphalan-prednisone (MP) backbone in advanced myeloma patients.
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