Potential role of novel nucleoside analogs in the treatment of acute myeloid leukemia.
OBJECTIVE
Nucleoside analogs remain a cornerstone in acute myeloid leukemia therapy. As many new nucleosides are being investigated in clinical trials, this review aims to update the current state of experience with these new compounds and where they may fit into treatment strategies for acute myeloid leukemia.


RESULTS
Many new nucleoside analogs are emerging with novel metabolic properties and mechanisms of action. Some have entered clinical trials and are actively investigated in the context of acute myeloid leukemia therapy. Clofarabine is the most-developed compound, and single-agent experience and combinations with other active agents in acute myeloid leukemia are being explored. Troxacitabine and sapacitabine are still in single-agent phases of their development and clinical experience is accumulating quickly.


CONCLUSIONS
Nucleosides remain the most important class of drugs in acute myeloid leukemia and the interest in new compounds is strong. The plethora of new analogs continues to provide ample opportunity to expand the effectiveness of these drugs in acute myeloid leukemia therapy. Furthermore, their unique mechanisms of action provide possibilities for mechanism-based combinations.
Faderl
Stefan
S
Department of Leukemia, Unit 428, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. sfaderl@mdanderson.org
Gandhi
Varsha
V
Kantarjian
Hagop M
HM
D000227:Adenine Nucleotides / Q000737:chemistry / Q000494:pharmacology; D000970:Antineoplastic Agents / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D001087:Arabinonucleosides / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D000077866:Clofarabine; D003596:Cytosine / Q000031:analogs & derivatives / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D004148:Dioxolanes / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D009705:Nucleosides / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*
D000227:Adenine Nucleotides; D000970:Antineoplastic Agents; D001087:Arabinonucleosides; D004148:Dioxolanes; D009705:Nucleosides; C074908:troxacitabine; D000077866:Clofarabine; D003596:Cytosine; C117959:sapacitabine