Molecularly targeted therapies in myelodysplastic syndromes and acute myeloid leukemias.
Although there has been significant progress in acute myeloid leukemia (AML) treatment in younger adults during the last decade, standard induction therapy still fails to induce remission in up to 40% of AML patients. Additionally, relapses are common in 50-70% of patients who achieve a complete remission, and only 20-30% of patients enjoy long-term disease-free survival. The natural history of myelodysplastic syndrome (MDS) is variable, with about half of the patients dying from cytopenic complications, and an additional 20-30% transforming to AML. The advanced age of the majority of MDS patients limits the therapeutic strategies often to supportive care. To address these shortcomings, much effort has been directed toward the development of novel treatment strategies that target the evolution and proliferation of malignant clones. Presented here is an overview of molecularly targeted therapies currently being tested in AML and MDS patients, with a focus on FMS-like tyrosine kinase 3 inhibitors, farnesyltransferase inhibitors, antiangiogenesis agents, DNA hypomethylation agents, and histone deacetylase inhibitors.
Morgan
Michael A
MA
Department of Hematology, Hemostasis and Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. christophreuter@yahoo.com
Reuter
Christoph W M
CW
D000367:Age Factors; D000818:Animals; D000970:Antineoplastic Agents / Q000378:metabolism / Q000627:therapeutic use*; D049109:Cell Proliferation / Q000187:drug effects; D019175:DNA Methylation / Q000187:drug effects; D018572:Disease-Free Survival; D004791:Enzyme Inhibitors / Q000378:metabolism / Q000627:therapeutic use*; D051548:Histone Acetyltransferases / Q000037:antagonists & inhibitors; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D009389:Neovascularization, Pathologic / Q000188:drug therapy / Q000378:metabolism; D011499:Protein Processing, Post-Translational / Q000187:drug effects; D016186:Receptor, Macrophage Colony-Stimulating Factor / Q000037:antagonists & inhibitors / Q000378:metabolism; D012074:Remission Induction / Q000379:methods
D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors; D051548:Histone Acetyltransferases; D016186:Receptor, Macrophage Colony-Stimulating Factor