Table 2.

New agents directed at molecular and other specific targets in clinical trials


New agents

Targets

Comments
All-trans retinoic acid   PML-RARα   Has changed standard of care in APL; improves DFS and OS in newly diagnosed patients.  
Arsenic trioxide   PML-RARα   Has changed standard of care in relapsed APL; induces high rate of hematologic and molecular CR; may cure some patients.  
Gemtuzumab ozogamicin   CD33   Modestly effective in patients with relapsed AML; role as additional agent in standard therapy currently being investigated.  
Farnesyltransferase inhibitor   Farnesylation of lamin A and HJJ-2   Modestly effective in high-risk patients newly diagnosed; role as adjunct to standard therapy under investigation.  
FLT3 tyrosine kinase inhibitors   Internal tandem duplications of FLT3  Most common gene mutation in AML. Some biologic activity in relapsed patients. Trials in combination with chemotherapy under way.  
MDR modulators: cyclosporine, PSC833, zosuquidar   P-glycoprotein and other multidrug resistance proteins   In general, results disappointing.  
Histone deacetylase inhibitors: phenylbutyrate, depsipeptide   Histone deacetylase   Clinical trials under way.  
BCL-2 antisense deoxynucleotide  BCL-2 protein   Clinical trials under way.  
Antiangiogenic agents
 
Vascular endothelial growth factor
 
Clinical trials under way.
 

New agents

Targets

Comments
All-trans retinoic acid   PML-RARα   Has changed standard of care in APL; improves DFS and OS in newly diagnosed patients.  
Arsenic trioxide   PML-RARα   Has changed standard of care in relapsed APL; induces high rate of hematologic and molecular CR; may cure some patients.  
Gemtuzumab ozogamicin   CD33   Modestly effective in patients with relapsed AML; role as additional agent in standard therapy currently being investigated.  
Farnesyltransferase inhibitor   Farnesylation of lamin A and HJJ-2   Modestly effective in high-risk patients newly diagnosed; role as adjunct to standard therapy under investigation.  
FLT3 tyrosine kinase inhibitors   Internal tandem duplications of FLT3  Most common gene mutation in AML. Some biologic activity in relapsed patients. Trials in combination with chemotherapy under way.  
MDR modulators: cyclosporine, PSC833, zosuquidar   P-glycoprotein and other multidrug resistance proteins   In general, results disappointing.  
Histone deacetylase inhibitors: phenylbutyrate, depsipeptide   Histone deacetylase   Clinical trials under way.  
BCL-2 antisense deoxynucleotide  BCL-2 protein   Clinical trials under way.  
Antiangiogenic agents
 
Vascular endothelial growth factor
 
Clinical trials under way.
 

FLT3 indicates Fms-like tyrosine kinase 3; MDR, multidrug resistance; BCL-2, B-CLL/lymphoma 2.