Find in Library
Search millions of books, articles, and more
Indexed Open Access Databases
Emerging Targeted Therapy for Specific Genomic Abnormalities in Acute Myeloid Leukemia
oleh: Sung-Gi Chi, Yosuke Minami
Format: | Article |
---|---|
Diterbitkan: | MDPI AG 2022-02-01 |
Deskripsi
We describe recent updates of existing molecular-targeting agents and emerging novel gene-specific strategies. FLT3 and IDH inhibitors are being tested in combination with conventional chemotherapy for both medically fit patients and patients who are ineligible for intensive therapy. FLT3 inhibitors combined with non-cytotoxic agents, such as BCL-2 inhibitors, have potential therapeutic applicability. The menin-MLL complex pathway is an emerging therapeutic target. The pathway accounts for the leukemogenesis in AML with <i>MLL</i>-rearrangement, <i>NPM1</i> mutation, and <i>NUP98</i> fusion genes. Potent menin-MLL inhibitors have demonstrated promising anti-leukemic effects in preclinical studies. The downstream signaling molecule SYK represents an additional target. However, the <i>TP53</i> mutation continues to remain a challenge. While the p53 stabilizer APR-246 in combination with azacitidine failed to show superiority compared to azacitidine monotherapy in a phase 3 trial, next-generation p53 stabilizers are now under development. Among a number of non-canonical approaches to <i>TP53</i>-mutated AML, the anti-CD47 antibody magrolimab in combination with azacitidine showed promising results in a phase 1b trial. Further, the efficacy was somewhat better in patients with the <i>TP53</i> mutation. Although clinical evidence has not been accumulated sufficiently, targeting activating <i>KIT</i> mutations and RAS pathway-related molecules can be a future therapeutic strategy.