DIY Vorinostat

10 May 2018 - Expensive drugs not so expensive

verinostatsmall.PNGIt does not stop: after Orkambi (link) and chenodeoxycholic acid (link) we now have another enterprising Dutch dispensing pharmacist home-brewing a an otherwise really expensive drug (NOS news). This time the drug is Vorinostat now available for patients at the AVL hospital not for the retail price of 100 euro per pill but for just 2 euro 50 (a typical course requires 4 pills per day).

This time there is catch though, the drug was only home-produced as part of a clinical trial of vorinostat in the treatment of a specific type of skin cancer (the usual target of the drug is in other types of cancer) making it a legal practice. The 2017 clinical trial was part of research carried out by cancer researcher René_Bernards and published in Cell (DOI), Bernards has been critical of expensive drugs in the past (DOI)

Suberanilohydroxamic acid is a fairly simple compound for a drug - a chain of anilide, suberoyl and hydroxamic acid - and discovered in 1991 by none other than Ronald Breslow and Paul Marks (patent). More synthesis can be found here: here and here.

As in the cases of Orkambi and chenodeoxycholic acid it is difficult to figure out if the mavericks involved do actually produce the compounds itself or take care of some other part of the process. Of course allowing being interviewed by news reporters is one thing and allowing them to film inside a production facility or laboratory is another. In the NOS news report a part of a laboratory swings into view but what to make of it. The blue box in the back has been identified as a Sciex Qtrap 5500 which is a LC-MS. So far, for a hospital apothecary quality control is well covered.