German Biotech Uses Epigenetics to Tackle Aggravating Side Effect in Cancer Patients

Severe itching is a major burden for people living with cutaneous T-cell lymphoma, but 4SC’s candidate can effectively reduce the sensation.

4SC is developing resminostat as a maintenance therapy for patients with cutaneous T-cell lymphoma (CTCL). CTCL is a blood cancer affecting T cells, and an uncomfortable side effect is severe itching. Until now, the underlying molecular mechanism was not understood, making treatment difficult. Using preclinical experiments, the company has elucidated the cause of itching and effectively treated it using resminostat. 4SC will wait for the results of its RESMAIN study before applying to take the drug to market.

Elevated interleukin-31 levels have been identified as the molecular cause of itching. Resminostat, a histone deacetylase, reactivates silenced genes and downregulates overactive regions of the genome. Genome-wide analysis before and after treatment saw a significant reduction in interleukin-31 levels. These results further support the drug’s pursuit for commercialization, following last month’s news that resminostat induced tumor shrinkage in patients with biliary tract cancer during a Phase I study.

There are already a few epigenetic drugs – largely histone deacetylases – on the market, for example, Belinostat. But, they have their issues, for example, limited applications and patient sensitivity. Initial results look promising, but we will see whether 4SC was right to continue in the field despite the concerns surrounding these drugs.

Image – Emily frost /

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