医学
拓扑异构酶
去甲柔比星
柔红霉素
威尼斯人
药理学
阿糖胞苷
专家意见
拓扑异构酶抑制剂
临床试验
肿瘤科
髓系白血病
重症监护医学
白血病
内科学
化学
慢性淋巴细胞白血病
酶
生物化学
作者
Minas P. Economides,Deborah McCue,Gautam Borthakur,Naveen Pemmaraju
标识
DOI:10.1080/14656566.2019.1621292
摘要
Introduction: Topoisomerase II inhibitors have long been used in the frontline and as salvage therapy for AML, with daunorubicin and idarubicin being prototypical agents in this therapeutic class, classically in combination with nucleoside analogs, e.g. cytarabine. Most recently, several other compounds from this drug class have or are being investigated.Areas covered: The current paper reviews older and newer topoisomerase II inhibitors in clinical development for the treatment of AML. The authors discuss the clinical use of these agents, current trials involving them as well as their safety profile. Important side effects of these medications including therapy-related AML (t-AML) are also covered.Expert opinion: Topoisomerase II inhibitors have helped improve outcomes in AML. Recently, the FDA approved several agents including CPX-351 for the treatment of secondary and t-AML. CPX-351 may have applicability in other high-risk myeloid diseases. Future directions include a combination of these agents with other targeted therapies. Finally, the authors believe that small molecule inhibitors, such as venetoclax and possibly immunotherapy options could also be incorporated to our treatment paradigm in selected patients.
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