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Enasidenib for the treatment of acute myeloid leukemia.
- Source :
-
Expert review of clinical pharmacology [Expert Rev Clin Pharmacol] 2018 Aug; Vol. 11 (8), pp. 755-760. Date of Electronic Publication: 2018 Jul 24. - Publication Year :
- 2018
-
Abstract
- Introduction: In August 2017, the United States Federal Drug Administration (FDA) approved enasidenib (Idhifa, Celgene/Agios) for adults with relapsed and refractory acute myelogenous leukemia (AML) with an IDH2 mutation. Enasidenib targets cells with mutant copies of isocitrate dehydrogenase-2 (IDH2), inhibiting the oncometabolite 2-hydroxyglutarte (2-HG) formed by the mutant IDH2. Areas covered: We review the studies leading to enasidenib's approval, as well as common side effects and safety issues experienced during the clinical trials. There is a focus on the diagnosis and treatment of these side effects including differentiation syndrome. Expert commentary: We are experiencing a revolution in the understanding of the mechanism of AML. A majority of the effort has been concentrated on targeting gene mutations or pathway activations with precision therapeutics. Enasidenib is beneficial in a patient population that previously had limited treatment options. However, given the fact that enasidenib is a highly specific inhibitor of an early stable mutation, it is questionable whether a strategy of targeting a single mutation or pathway in relapsed AML will allow for better than the 20% complete remission (CR) rate observed with this therapy. The proper role for single mutation targeting in AML needs to be carefully considered.
- Subjects :
- Adult
Aminopyridines adverse effects
Aminopyridines pharmacology
Antineoplastic Agents adverse effects
Antineoplastic Agents pharmacology
Humans
Isocitrate Dehydrogenase genetics
Leukemia, Myeloid, Acute genetics
Leukemia, Myeloid, Acute pathology
Mutation
Triazines adverse effects
Triazines pharmacology
Aminopyridines therapeutic use
Antineoplastic Agents therapeutic use
Leukemia, Myeloid, Acute drug therapy
Triazines therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1751-2441
- Volume :
- 11
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Expert review of clinical pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 29770715
- Full Text :
- https://doi.org/10.1080/17512433.2018.1477585