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Lachowiez CA, DiNardo CD, Loghavi S. Molecularly Targeted Therapy in Acute Myeloid Leukemia: Current Treatment Landscape and Mechanisms of Response and Resistance. Cancers (Basel) 2023; 15:1617. [PMID: 36900407 PMCID: PMC10001191 DOI: 10.3390/cancers15051617] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Treatment for acute myeloid leukemia (AML) has evolved rapidly over the last decade as improved understanding of cytogenetic and molecular drivers of leukemogenesis refined survival prognostication and enabled development of targeted therapeutics. Molecularly targeted therapies are now approved for the treatment of FLT3 and IDH1/2-mutated AML and additional molecularly and cellularly targeted therapeutics are in development for defined patient subgroups. Alongside these welcome therapeutic advancements, increased understanding of leukemic biology and treatment resistance has resulted in clinical trials investigating combinations of cytotoxic, cellular, and molecularly targeted therapeutics resulting in improved response and survival outcomes in patients with AML. Herein, we comprehensively review the current landscape of IDH and FLT3 inhibitors in clinical practice for the treatment of AML, highlight known resistance mechanisms, and discuss new cellular or molecularly targeted therapies currently under investigation in ongoing early phase clinical trials.
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Affiliation(s)
- Curtis A. Lachowiez
- Department of Medicine, Division of Hematology/Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Courtney D. DiNardo
- Department of Leukemia and Hematopathology, The University of Texas, MD Anderson, Houston, TX 77030, USA
| | - Sanam Loghavi
- Department of Leukemia and Hematopathology, The University of Texas, MD Anderson, Houston, TX 77030, USA
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Ramkissoon LA, Buhlinger K, Nichols A, Coombs CC, Foster MC, Galeotti J, Kaiser-Rogers K, Richardson DR, Montgomery ND, Zeidner JF. Clonal evolution of Philadelphia chromosome in acute myeloid leukemia after enasidenib treatment. Leuk Lymphoma 2021; 62:3035-3038. [PMID: 34151687 DOI: 10.1080/10428194.2021.1941928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Lori A Ramkissoon
- Department of Pathology & Laboratory Medicine, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Kaitlyn Buhlinger
- Lineberger Comprehensive Cancer Center, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Angela Nichols
- Lineberger Comprehensive Cancer Center, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Catherine C Coombs
- Lineberger Comprehensive Cancer Center, The University of North Carolina School of Medicine, Chapel Hill, NC, USA.,Division of Hematology, Department of Medicine, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Matthew C Foster
- Lineberger Comprehensive Cancer Center, The University of North Carolina School of Medicine, Chapel Hill, NC, USA.,Division of Hematology, Department of Medicine, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Jonathan Galeotti
- Department of Pathology & Laboratory Medicine, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Kathleen Kaiser-Rogers
- Department of Pathology & Laboratory Medicine, The University of North Carolina School of Medicine, Chapel Hill, NC, USA.,Department of Pediatrics, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Daniel R Richardson
- Lineberger Comprehensive Cancer Center, The University of North Carolina School of Medicine, Chapel Hill, NC, USA.,Division of Hematology, Department of Medicine, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Nathan D Montgomery
- Department of Pathology & Laboratory Medicine, The University of North Carolina School of Medicine, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Joshua F Zeidner
- Lineberger Comprehensive Cancer Center, The University of North Carolina School of Medicine, Chapel Hill, NC, USA.,Division of Hematology, Department of Medicine, The University of North Carolina School of Medicine, Chapel Hill, NC, USA
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