Wingelhofer Bettina, Somervaille Tim C P
Leukaemia Biology Laboratory, Cancer Research UK Manchester Institute, University of Manchester, Manchester, United Kingdom.
Front Oncol. 2019 Sep 6;9:850. doi: 10.3389/fonc.2019.00850. eCollection 2019.
Acute myeloid leukemia (AML) is a genetically heterogeneous malignancy for which treatment options have been largely limited to cytotoxic chemotherapy for the past four decades. Next-generation sequencing and other approaches have identified a spectrum of genomic and epigenomic alterations that contribute to AML initiation and maintenance. The key role of epigenetic modifiers and the reversibility of epigenetic changes have paved the way for evaluation of a new set of drug targets, and facilitated the design of novel candidate treatment strategies. More recently, seven new targeted therapies have been FDA-approved demonstrating successful implementation of the past decades' research. In this review, we will summarize the most recent advances in targeted therapeutics designed for a focused group of key epigenetic regulators in AML, outline their mechanism of action and their current status in clinical development. Furthermore, we will discuss promising new approaches for epigenetic targeted treatment in AML which are currently being tested in pre-clinical trials.
急性髓系白血病(AML)是一种基因异质性恶性肿瘤,在过去四十年里,其治疗选择在很大程度上局限于细胞毒性化疗。新一代测序和其他方法已经确定了一系列导致AML起始和维持的基因组和表观基因组改变。表观遗传修饰因子的关键作用以及表观遗传变化的可逆性为评估一组新的药物靶点铺平了道路,并促进了新型候选治疗策略的设计。最近,七种新的靶向疗法已获美国食品药品监督管理局(FDA)批准,证明了过去几十年研究的成功实施。在本综述中,我们将总结针对AML中一组关键表观遗传调节因子设计的靶向治疗的最新进展,概述其作用机制以及它们在临床开发中的现状。此外,我们还将讨论目前正在临床前试验中进行测试的AML表观遗传靶向治疗的有前景的新方法。