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伴有FLT3突变的急性髓系白血病的治疗策略:专利综述

Strategies for the treatment of acute myeloid leukemia with FLT3 mutations: a patent review.

作者信息

Gorecki Lukas, Reznickova Eva, Krystof Vladimir, Rezacova Martina, Ceckova Martina, Korabecny Jan

机构信息

Department of Toxicology and Military Pharmacy, Military Faculty of Medicine, University of Defence, Hradec Kralove, Czech Republic.

Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.

出版信息

Expert Opin Ther Pat. 2025 Feb;35(2):137-164. doi: 10.1080/13543776.2024.2446224. Epub 2025 Jan 5.

Abstract

INTRODUCTION

Approximately one-third of all AML patients have a mutation in the () gene, which is associated with a poor prognosis in these individuals. The 2017 approval of midostaurin, the first FLT3 inhibitor, spurred extensive development of more potent and selective inhibitors with an improved safety profile.

AREAS COVERED

This review analyzes patent inventions for the treatment of AML using FLT3 inhibitors, covering developments from the earliest to the most recent, disclosed in 2024. Our search using the global Espacenet database identified numerous compounds with low nanomolar inhibitory concentrations against FLT3-ITD and FLT3-TKD mutants. These compounds have shown promise in preclinical studies. Co-inhibition strategies and combinatorial therapies to overcome resistance and enhance anti-leukemic efficacy are also discussed.

EXPERT OPINION

Recent patents highlight advances in the field of FLT3 inhibitors with a focus on overcoming resistance, improving selectivity and potency. Future strategies may include third-generation inhibitors such as type III allosteric inhibitors, irreversible inhibitors, or PROTACs. Personalized medicine approaches utilizing genetic profiling to tailor therapies are emphasized. Exploration of novel combination regimens with emerging therapies like CAR T-cell therapy, immune checkpoint inhibitors, and small molecules targeting critical AML pathways is ongoing to further enhance anti-leukemic efficacy.

摘要

引言

大约三分之一的急性髓系白血病(AML)患者的()基因存在突变,这与这些患者的不良预后相关。2017年,首个FLT3抑制剂米哚妥林获批,促使人们广泛研发更有效、选择性更高且安全性更好的抑制剂。

涵盖领域

本综述分析了使用FLT3抑制剂治疗AML的专利发明,涵盖了从最早到2024年披露的最新进展。我们使用全球Espacenet数据库进行检索,发现了许多对FLT3-ITD和FLT3-TKD突变体具有低纳摩尔抑制浓度的化合物。这些化合物在临床前研究中显示出了前景。还讨论了克服耐药性和增强抗白血病疗效的联合抑制策略和联合疗法。

专家观点

近期专利突出了FLT3抑制剂领域在克服耐药性、提高选择性和效力方面的进展。未来策略可能包括第三代抑制剂,如III型别构抑制剂、不可逆抑制剂或蛋白水解靶向嵌合体(PROTAC)。强调了利用基因谱分析来定制治疗方案的个性化医疗方法。目前正在探索与嵌合抗原受体(CAR)T细胞疗法、免疫检查点抑制剂和靶向关键AML途径的小分子等新兴疗法的新型联合治疗方案,以进一步提高抗白血病疗效。

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