title: New Therapeutic Strategies in Acute Lymphocytic Leukemia.
abstract: Most drugs used in standard regimens for acute lymphoblastic leukemia (ALL) were developed more than 30 years ago. Since that time, several new drugs have been developed and incorporated into ALL treatment. In spite of this, novel therapeutic approaches are still needed to improve outcomes for high-risk or relapsed ALL. This manuscript discusses newer treatment strategies, including purine nucleoside analogs, monoclonal antibodies, antibody drug conjugates, mammalian target of rapamycin (mTOR) inhibitors, proteasome inhibitors, histone deacetylase (HDAC) inhibitors, hypomethylating agents, spleen tyrosine kinase inhibitors, Bruton's tyrosine kinase (BTK) inhibitors, Janus kinase-signal transducer and activator of transcription (JAK-STAT) inhibitors, anti-programmed cell death protein (anti-PD-1) antibodies, mitogen-activated protein kinase (MEK) inhibitors, CXCR4 antagonists, poly (ADP-ribose) polymerase (PARP) inhibitors, and FMS-like tyrosine kinase 3 (FLT3) inhibitors. Additionally, this manuscript discusses the impact of diagnostic approaches on management of ALL. Specifically, minimal residual disease is increasingly felt to be important and will likely dramatically impact the care of ALL patients in the near future.
authors.affiliation: Division of Hematology/Oncology, University of Virginia Health System, 1300 Jefferson Park Avenue, Room 6023, PO Box 800716, Charlottesville, VA, 22903, USA.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Man
authors.affiliation: Department of Pharmacy Services, University of Virginia Medical Center, Charlottesville, VA, 22903, USA.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Morris
authors.affiliation: Division of Hematology/Oncology, University of Virginia Health System, 1300 Jefferson Park Avenue, Room 6023, PO Box 800716, Charlottesville, VA, 22903, USA. MK2PV@hscmail.mcc.virginia.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Keng
mesh_terms: D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D002986:Clinical Trials as Topic; D044127:Epigenesis, Genetic / Q000187:drug effects; D056572:Histone Deacetylase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D018796:Immunoconjugates / Q000494:pharmacology / Q000627:therapeutic use; D058990:Molecular Targeted Therapy; D018365:Neoplasm, Residual / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D061988:Proteasome Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D056572:Histone Deacetylase Inhibitors; D018796:Immunoconjugates; D061988:Proteasome Inhibitors; D047428:Protein Kinase Inhibitors
keywords: Acute lymphoblastic leukemia; Acute lymphocytic leukemias; Antibody drug conjugates; Monoclonal antibodies; Purine nucleoside analogs; Therapeutic approaches