HIV Infections
Conditions
Keywords
HIV latency, Disulfiram, Vorinostat, Latency Reversing Agents, Histone Deacetylase Inhibitors (HDACi)
Brief summary
Antiretroviral therapy (ART) dramatically reduces Human Immunodeficiency Virus (HIV) replication leading to restoration of immune function and a near normal life expectancy, but treatment is lifelong and there is no cure. The major barrier to a cure is the persistence of long lived cluster of differentiation 4 (CD4+) T-cells that contain a silenced form of HIV, called HIV latency. The purpose of this research is to investigate whether it may be possible to reduce the amount of dormant HIV infection in immune cells, by turning on or activating the virus and hence force it out of the latently infected memory T cells. This leads to production of HIV by the cell, which will either die or will be recognized and eliminated by the immune system. As very few T cells are latently infected with HIV, the death of these cells is not expected to affect the function of the immune system and further infection of new cells is expected to be prevented by ART.
Detailed description
One strategy aimed at reducing the frequency of latently infected cells in HIV-infected individuals on antiretroviral therapy (ART) is the use of pharmacological agents to reverse HIV latency, thereby initiating virus-mediated cell lysis or immune-mediated killing. Recent clinical trials of latency reversing agents (LRAs) in HIV infected subjects on ART, including histone deacetylase inhibitors (HDACi) and the anti-alcoholism drug disulfiram, have shown that inducing an increase in Cell Associated Unspliced (CA-US) HIV RNA or plasma HIV RNA is possible. Yet, these interventions did not have a demonstrable effect on the frequency of latently infected cells or time to viral rebound after cessation of ART, potentially because latency reversal alone didn't trigger an adequate immune response or cell death or that the potency of latency reversal with a single-agent intervention over a very short period of time, lacked sufficient potency, as suggested by recent in vitro studies. It is highly likely that long-term remission off ART will require interventions that lead to both a reduction in latently infected cells and an increase in HIV-specific immunity, therefore identifying a strategy to increase viral antigens on the surface of latently infected cells will be a key component of this strategy.
Interventions
DRUGDisulfiram, (National Drug Code) NDC 0378-4141-01
This study will provide open label disulfiram. Participants will take 2 grams (4x500mg tablets) of disulfiram per day for a total of 28 days
DRUGVorinostat, NDC 00006-0568-40
This study will provide open label vorinostat. Participants will take 400mg (4x100mg capsules) of vorinostat per day on days 8, 9, 10 and days 22, 23, 24.
Sponsors
Merck Sharp & Dohme LLC
The Alfred
University of Melbourne
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Masking description
Open Label
Intervention model description
Single arm, single site,
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age 18-65 years with documented HIV-1 infection (antibody positive or detectable plasma HIV-1 RNA) * Receiving combination ART with plasma HIV RNA \<50 copies/mL for \>3 years * CD4+ T cell count \>350 microliter at screening * Able to provide informed consent * Willing to abstain from alcohol consumption from one day before to 14 days after completing 28 days of disulfiram * One month post influenza vaccine (from screening visit) * Women of non-child-bearing potential defined as \> 12 months of spontaneous amenorrhea and ≥ 45 years of age, or documented medical history of one of the following: hysterectomy, bilateral oophorectomy or tubal ligation. * Women of Child Bearing Potential (WOCBP) with a negative pregnancy test at Screening and agrees to use one of the study protocol specified methods of contraception to avoid pregnancy
Exclusion criteria
* Current alcohol use disorder or hazardous alcohol use (\>7 drinks per week for women or \> 14 drinks per week for men) as determined by clinical evaluation * Current or recent (in the last 4 days) use of metronidazole or any drug formulation that contains alcohol or that might contain alcohol, including the gelatin capsule and liquid formulations of ritonavir, ritonavir/lopinavir, amprenavir and fosamprenavir, and alcohol-containing preparations such as cough syrups, tonics etc. * Current use of tipranavir or Maraviroc * Current use of zidovudine, stavudine or didanosine (as disulfiram potentially has potent irreversible inhibitory effects on mitochondrial metabolism and hence could exacerbate the toxicity of these drugs) * Concurrent use of rivaroxaban (a CYP3A metabolized medication) as the cytochrome P450 inhibitory effects of disulfiram on rivaroxaban are unknown * Current use of warfarin * Individuals who intend to modify antiretroviral therapy during the study period for any reason * Significant myocardial disease (current myocarditis or reduced left ventricular ejection fraction below the lower limit of normal) or diagnosed coronary artery disease * Significant renal disease (eGFR \<50 milliliter/minute) * History of psychosis, seizure disorder, abnormal electroencephalogram or brain damage with significant persisting neurological deficit * Prior malignancy active within the previous 3 years except for local curable cancers that have been apparently cured, such as basal or squamous cell skin cancer, superficial bladder cancer or carcinoma in situ of the prostate, cervix or breast. * Known hypersensitivity to disulfiram or vorinostat or contraindications to treatment with these agents * Participation in another latency reversal study or receipt of vorinostat or disulfiram in the previous 12 months before starting the investigational treatment * Any significant acute medical illness requiring hospitalization within preceding 8 weeks * Hepatitis B (HBV) or hepatitis C (HCV) co-infection as determined by detection of HBsAg or HCV RNA (Individuals with prior hepatitis infection that is now cleared are eligible for enrolment) * Receipt of immunomodulating agents (excluding immunization) or systemic chemotherapeutic agents within 28 days prior to study entry * Current or recent gastrointestinal disease or surgery that may impact the absorption of the investigational drug * Active substance use that in the opinion of the investigator will prevent adequate compliance with study procedures * Women who are currently pregnant or breastfeeding * Women of Child Bearing Potential (WOCBP) who are unwilling or unable to use an acceptable method of contraception to avoid pregnancy * Unable or unwilling to adhere to protocol procedures * The following laboratory values within 6 weeks before starting the investigational drug (lab tests may be repeated to obtain acceptable values before failure at screening is concluded) * Hepatic transaminases (AST or ALT) ≥3 x upper limit of normal (ULN) * Serum total bilirubin ≥1.5 x ULN * eGFR \<50 milliliter/min * Hemoglobin \<11.0 g/deciliter * Platelet count ≤100 x10\^9/L (liter) * Absolute neutrophil count ≤1.5x10\^9/L * Serum potassium, magnesium, phosphorus outside normal limits * Total calcium (corrected for serum albumin) or ionized calcium ≤ lower normal limits
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Day 11 Plasma HIV RNA Relative to Baseline | Baseline and 11 days | The primary endpoint was to determine the change from baseline to day 11 of plasma HIV RNA levels after 11 continuous days of disulfiram with administration of vorinostat on days 8, 9 and 10 in HIV infected individuals on suppressive ART. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Treatment-Emergent Adverse Events | Adverse events were collected continuously throughout the study duration from day 1 on treatment until 2 months since last dose of study drug, an average duration of 3 months | This secondary outcome was to determine the Incidence of treatment-emergent adverse events \[Safety and Tolerability\] during a 28 day course of continuous disulfiram with intermittent administration of 3 days of vorinostat on two occasions in HIV infected individuals on suppressive ART. An adverse event is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. An SAE is defined as any untoward medical occurrence that; results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect, other situations as judged by physician. Systematic assessments of adverse events were performed at each visit, including unscheduled visits |
| Plasma HIV RNA Relative to Baseline at Additional Time Points | Baseline to Days 8, 15, 21, 38, 59, 196, 197. Data is reported for days where samples were collected for each participant. | This secondary outcome was to determine the fold change in plasma HIV RNA levels at additional time points during and after 11 continuous days of disulfiram with administration of vorinostat on days 8, 9 and 10 in HIV infected individuals on suppressive ART. |
Other
| Measure | Time frame | Description |
|---|---|---|
| HIV Levels Relative to Baseline | Day 56 | This outcome was to measure the frequency of inducible virus as measured by Tat/rev limiting dilution assay (TILDA) in peripheral blood CD4+ T cells relative to baseline. Not conducted as part of the analysis and there are no future plans to assess this outcome, as analysis from 2 participants would not provide any meaningful results, given that the participants did not manage to complete the treatment course. |
| Vorinostat Concentration in Plasma | Baseline and days 8, 11, 15, 21, 37, 58. Data is reported for days where samples were collected for each participant. | This outcome was to measure the concentrations of vorinostat (including its metabolites) in plasma. |
| HIV RNA Transcription Relative to Baseline at Additional Time Points | Baseline to Days 8, 11, 15, 21, 38, 59, 196, 197. Data is reported for days where samples were collected for each participant. | This secondary outcome was to measure HIV transcription measured by cell-associated unspliced HIV RNA (CA-US HIV RNA) in peripheral blood CD4+ T cells relative to baseline |
| p24 Expression in CD4+ T-cells Relative to Baseline | Baseline and Days 8, 11, 15, 21, 37, 58, 196 and 197. Data is reported for days where samples were collected for each participant. | This outcome was to measure the p24 expression in CD4+ T-cells relative to baseline |
| Disulfiram Concentration in Plasma | Days 8, 11, 22, 25, 28, 56 and 196 Data is reported for days where samples were collected for each participant. | This outcome was to measure the concentrations of disulfiram (including its metabolites) in plasma |
| Cell Associated Total HIV DNA Relative to Baseline at Additional Points | Baseline and Days 38, 59, 196 and 197. Data is reported for days where results are available for each participant. | This outcome was to measure Cell-associated total and integrated HIV DNA in peripheral blood CD4+ T cells relative to baseline |
| Cell-associated Integrated HIV DNA Relative to Baseline at Additional Points | Baseline to Days 38, 59, 197, 196. Data is reported for days where samples were collected for each participant. | This outcome was to measure cell-associated integrated HIV DNA in peripheral blood CD4+ T cells relative to baseline |
Countries
Australia
Participant flow
Recruitment details
Study recruitment began August 8, 2017. Participants were enrolled for screening between this date and when recruitment into the study was suspended on October 19, 2017. In the end, 5 participants were consented into the study and found eligible to begin treatment. Only 2 participants received treatment before the study was suspended.
Pre-assignment details
Enrolled participants who were screened and found eligible to begin on-study treatment were started in a staggered-start. Essentially this meant that the first 2 eligible participants started treatment at the same time. Only once the treatment phase had been completed would the next 2 eligible participants begin the on-study treatment phase.
Participants by arm
| Arm | Count |
|---|---|
| Experimental Participants current ART regimen:
2 grams disulfiram by mouth per day for a total of 28 days
400mg vorinostat by mouth per day on days 8, 9,10 and days 22, 23, 24
Disulfiram, (National Drug Code) NDC 0378-4141-01: This study will provide open label disulfiram. Participants will take 2 grams (4x500mg tablets) of disulfiram per day for a total of 28 days
Vorinostat, NDC 00006-0568-40: This study will provide open label vorinostat. Participants will take 400mg (4x100mg capsules) of vorinostat per day on days 8, 9, 10 and days 22, 23, 24. | 2 |
| Total | 2 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 2 |
Baseline characteristics
| Characteristic | Experimental |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 1 Participants |
| Age, Categorical Between 18 and 65 years | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 2 Participants |
| Region of Enrollment Australia | 2 participants |
| Sex: Female, Male Female | 0 Participants |
| Sex: Female, Male Male | 2 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 2 / 2 |
| other Total, other adverse events | 2 / 2 |
| serious Total, serious adverse events | 2 / 2 |
Outcome results
Primary
Day 11 Plasma HIV RNA Relative to Baseline
The primary endpoint was to determine the change from baseline to day 11 of plasma HIV RNA levels after 11 continuous days of disulfiram with administration of vorinostat on days 8, 9 and 10 in HIV infected individuals on suppressive ART.
Time frame: Baseline and 11 days
Population: The analysis included all participants who received at least one dose of study drug.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Experimental | Day 11 Plasma HIV RNA Relative to Baseline | Participant 1 | 1 Fold change from baseline to day 11 |
| Experimental | Day 11 Plasma HIV RNA Relative to Baseline | Participant 2 | 13.5 Fold change from baseline to day 11 |
Secondary
Incidence of Treatment-Emergent Adverse Events
This secondary outcome was to determine the Incidence of treatment-emergent adverse events \[Safety and Tolerability\] during a 28 day course of continuous disulfiram with intermittent administration of 3 days of vorinostat on two occasions in HIV infected individuals on suppressive ART. An adverse event is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. An SAE is defined as any untoward medical occurrence that; results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect, other situations as judged by physician. Systematic assessments of adverse events were performed at each visit, including unscheduled visits
Time frame: Adverse events were collected continuously throughout the study duration from day 1 on treatment until 2 months since last dose of study drug, an average duration of 3 months
Population: All participants who received one dose of treatment.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Experimental | Incidence of Treatment-Emergent Adverse Events | Any SAE | 2 Participants |
| Experimental | Incidence of Treatment-Emergent Adverse Events | Any non-SAE | 2 Participants |
Secondary
Plasma HIV RNA Relative to Baseline at Additional Time Points
This secondary outcome was to determine the fold change in plasma HIV RNA levels at additional time points during and after 11 continuous days of disulfiram with administration of vorinostat on days 8, 9 and 10 in HIV infected individuals on suppressive ART.
Time frame: Baseline to Days 8, 15, 21, 38, 59, 196, 197. Data is reported for days where samples were collected for each participant.
Population: All participants who received at least one dose of treatment was analyzed.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Experimental | Plasma HIV RNA Relative to Baseline at Additional Time Points | Participant 1 - Day 8 | 1 Fold change from baseline |
| Experimental | Plasma HIV RNA Relative to Baseline at Additional Time Points | Participant 1 - Day 59 | 1 Fold change from baseline |
| Experimental | Plasma HIV RNA Relative to Baseline at Additional Time Points | Participant 1 - Day 197 | 1 Fold change from baseline |
| Experimental | Plasma HIV RNA Relative to Baseline at Additional Time Points | Participant 2 - Day 8 | 9.9 Fold change from baseline |
| Experimental | Plasma HIV RNA Relative to Baseline at Additional Time Points | Participant 2 - Day 15 | 14.4 Fold change from baseline |
| Experimental | Plasma HIV RNA Relative to Baseline at Additional Time Points | Participant 2 - Day 21 | 45.9 Fold change from baseline |
| Experimental | Plasma HIV RNA Relative to Baseline at Additional Time Points | Participant 2 - Day 38 | 18.3 Fold change from baseline |
| Experimental | Plasma HIV RNA Relative to Baseline at Additional Time Points | Participant 2 - Day 196 | 5 Fold change from baseline |
Other Pre-specified
Cell-associated Integrated HIV DNA Relative to Baseline at Additional Points
This outcome was to measure cell-associated integrated HIV DNA in peripheral blood CD4+ T cells relative to baseline
Time frame: Baseline to Days 38, 59, 197, 196. Data is reported for days where samples were collected for each participant.
Population: All participants who received at least one dose of treatment
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Experimental | Cell-associated Integrated HIV DNA Relative to Baseline at Additional Points | Participant 1 - Day 59 | 1.47 Fold change from baseline |
| Experimental | Cell-associated Integrated HIV DNA Relative to Baseline at Additional Points | Participant 1 - Day 197 | 2.52 Fold change from baseline |
| Experimental | Cell-associated Integrated HIV DNA Relative to Baseline at Additional Points | Participant 2 - Day 38 | 0.37 Fold change from baseline |
| Experimental | Cell-associated Integrated HIV DNA Relative to Baseline at Additional Points | Participant 2 -Day 196 | 1.46 Fold change from baseline |
Other Pre-specified
Cell Associated Total HIV DNA Relative to Baseline at Additional Points
This outcome was to measure Cell-associated total and integrated HIV DNA in peripheral blood CD4+ T cells relative to baseline
Time frame: Baseline and Days 38, 59, 196 and 197. Data is reported for days where results are available for each participant.
Population: All participants who received at least one dose of treatment
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Experimental | Cell Associated Total HIV DNA Relative to Baseline at Additional Points | Participant 1 - Day 59 | 0.7 Fold change from baseline |
| Experimental | Cell Associated Total HIV DNA Relative to Baseline at Additional Points | Participant 1 - Day 197 | 0.72 Fold change from baseline |
| Experimental | Cell Associated Total HIV DNA Relative to Baseline at Additional Points | Participant 2 - Day 38 | 0.74 Fold change from baseline |
| Experimental | Cell Associated Total HIV DNA Relative to Baseline at Additional Points | Participant 2 - Day 196 | 1.72 Fold change from baseline |
Other Pre-specified
Disulfiram Concentration in Plasma
This outcome was to measure the concentrations of disulfiram (including its metabolites) in plasma
Time frame: Days 8, 11, 22, 25, 28, 56 and 196 Data is reported for days where samples were collected for each participant.
Population: All participants who received at least one dose of treatment.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Experimental | Disulfiram Concentration in Plasma | Participants 1 and 2 - Day 8 | NA ng/mL |
| Experimental | Disulfiram Concentration in Plasma | Participants 1 and 2 - Day 11 | NA ng/mL |
| Experimental | Disulfiram Concentration in Plasma | Participant 1 - Day 58 | NA ng/mL |
| Experimental | Disulfiram Concentration in Plasma | Participant 2 -Day 15 | NA ng/mL |
| Experimental | Disulfiram Concentration in Plasma | Participant 2 - Day 21 | NA ng/mL |
Other Pre-specified
HIV Levels Relative to Baseline
This outcome was to measure the frequency of inducible virus as measured by Tat/rev limiting dilution assay (TILDA) in peripheral blood CD4+ T cells relative to baseline. Not conducted as part of the analysis and there are no future plans to assess this outcome, as analysis from 2 participants would not provide any meaningful results, given that the participants did not manage to complete the treatment course.
Time frame: Day 56
Population: This primary endpoint was not performed. See outcome measure description for reasoning
Other Pre-specified
HIV RNA Transcription Relative to Baseline at Additional Time Points
This secondary outcome was to measure HIV transcription measured by cell-associated unspliced HIV RNA (CA-US HIV RNA) in peripheral blood CD4+ T cells relative to baseline
Time frame: Baseline to Days 8, 11, 15, 21, 38, 59, 196, 197. Data is reported for days where samples were collected for each participant.
Population: All participants who had received at least 1 dose of treatment
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Experimental | HIV RNA Transcription Relative to Baseline at Additional Time Points | Participant 1 - Day 8 | 3.33 Fold change from baseline |
| Experimental | HIV RNA Transcription Relative to Baseline at Additional Time Points | Participant 1 - Day 11 | 5.13 Fold change from baseline |
| Experimental | HIV RNA Transcription Relative to Baseline at Additional Time Points | Participant 1 - Day 59 | 4.56 Fold change from baseline |
| Experimental | HIV RNA Transcription Relative to Baseline at Additional Time Points | Participant 1 - Day 197 | 12.72 Fold change from baseline |
| Experimental | HIV RNA Transcription Relative to Baseline at Additional Time Points | Participant 2 - Day 8 | 1.56 Fold change from baseline |
| Experimental | HIV RNA Transcription Relative to Baseline at Additional Time Points | Participant 2 - Day 11 | 0.91 Fold change from baseline |
| Experimental | HIV RNA Transcription Relative to Baseline at Additional Time Points | Participant 2 - Day 15 | 0.64 Fold change from baseline |
| Experimental | HIV RNA Transcription Relative to Baseline at Additional Time Points | Participant 2 - Day 21 | 0.72 Fold change from baseline |
| Experimental | HIV RNA Transcription Relative to Baseline at Additional Time Points | Participant 2 - Day 38 | 0.41 Fold change from baseline |
| Experimental | HIV RNA Transcription Relative to Baseline at Additional Time Points | Participant 2 - Day 196 | 3.77 Fold change from baseline |
Other Pre-specified
p24 Expression in CD4+ T-cells Relative to Baseline
This outcome was to measure the p24 expression in CD4+ T-cells relative to baseline
Time frame: Baseline and Days 8, 11, 15, 21, 37, 58, 196 and 197. Data is reported for days where samples were collected for each participant.
Population: All participants who received at least one dose of treatment.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Experimental | p24 Expression in CD4+ T-cells Relative to Baseline | Participant 1 - Day 8 | 0.83 Fold change from baseline |
| Experimental | p24 Expression in CD4+ T-cells Relative to Baseline | Participant 1 - Day 11 | 0.78 Fold change from baseline |
| Experimental | p24 Expression in CD4+ T-cells Relative to Baseline | Participant 1 - Day 58 | 2.13 Fold change from baseline |
| Experimental | p24 Expression in CD4+ T-cells Relative to Baseline | Participant 1 - Day 197 | 0.96 Fold change from baseline |
| Experimental | p24 Expression in CD4+ T-cells Relative to Baseline | Participant 2 - Day 8 | 1.96 Fold change from baseline |
| Experimental | p24 Expression in CD4+ T-cells Relative to Baseline | Participant 2 - Day 11 | 0.91 Fold change from baseline |
| Experimental | p24 Expression in CD4+ T-cells Relative to Baseline | Participant 2 - Day 15 | 1.26 Fold change from baseline |
| Experimental | p24 Expression in CD4+ T-cells Relative to Baseline | Participant 2 - Day 21 | 1 Fold change from baseline |
| Experimental | p24 Expression in CD4+ T-cells Relative to Baseline | Participant 2 - Day 38 | 1.09 Fold change from baseline |
| Experimental | p24 Expression in CD4+ T-cells Relative to Baseline | Participant 2 - Day 196 | 1.39 Fold change from baseline |
Other Pre-specified
Vorinostat Concentration in Plasma
This outcome was to measure the concentrations of vorinostat (including its metabolites) in plasma.
Time frame: Baseline and days 8, 11, 15, 21, 37, 58. Data is reported for days where samples were collected for each participant.
Population: All participants who received at least one dose of treatment.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Experimental | Vorinostat Concentration in Plasma | Participant 1 - Day 11 | 6.52 ng/mL |
| Experimental | Vorinostat Concentration in Plasma | Participant - Day 58 | NA ng/mL |
| Experimental | Vorinostat Concentration in Plasma | Participant 2 - Baseline | NA ng/mL |
| Experimental | Vorinostat Concentration in Plasma | Participant 2 - Day 8 | NA ng/mL |
| Experimental | Vorinostat Concentration in Plasma | Participant 2 - Day 11 | 7.6 ng/mL |
| Experimental | Vorinostat Concentration in Plasma | Participant 1 - Baseline | NA ng/mL |
| Experimental | Vorinostat Concentration in Plasma | Participant 1 - Day 8 | NA ng/mL |
| Experimental | Vorinostat Concentration in Plasma | Participant 2 - Day 15 | NA ng/mL |
| Experimental | Vorinostat Concentration in Plasma | Participant 2 - Day 21 | NA ng/mL |
| Experimental | Vorinostat Concentration in Plasma | Participant 2 - Day 38 | NA ng/mL |