What’s next after hypomethylating agents failure in myeloid neoplasms? A rational approach Review
| Authors: | Awada, H.; Gurnari, C.; Xie, Z.; Bewersdorf, J. P.; Zeidan, A. M. |
| Review Title: | What’s next after hypomethylating agents failure in myeloid neoplasms? A rational approach |
| Abstract: | Hypomethylating agents (HMA) such as azacitidine and decitabine are a mainstay in the current management of patients with myelodysplastic syndromes/neoplasms (MDS) and acute myeloid leukemia (AML) as either single agents or in multidrug combinations. Resistance to HMA is not uncommon, and it can result due to several tumor cellular adaptations. Several clinical and genomic factors have been identified as predictors of HMA resistance. However, the management of MDS/AML patients after the failure of HMA remains challenging in the absence of standardized guidelines. Indeed, this is an area of active research with several potential therapeutic agents currently under development, some of which have demonstrated therapeutic potential in early clinical trials, especially in cases with particular mutational characteristics. Here, we review the latest findings and give a rational approach for such a challenging scenario. © 2023 by the authors. |
| Keywords: | treatment failure; unclassified drug; gene mutation; fludarabine; lenalidomide; review; cancer combination chemotherapy; drug withdrawal; monotherapy; cytarabine; antineoplastic agent; antineoplastic activity; mutational analysis; prediction; cancer resistance; patient care; myelodysplastic syndrome; allogeneic hematopoietic stem cell transplantation; drug substitution; anthracycline; clofarabine; azacitidine; gemtuzumab ozogamicin; cladribine; randomized controlled trial (topic); molecularly targeted therapy; acute myeloid leukemia; treosulfan; cancer prognosis; decitabine; human; venetoclax; rigosertib; cytarabine plus daunorubicin; guadecitabine; hypomethylating agents; enasidenib; ivosidenib; olutasidenib; myelodysplastic syndromes/neoplasms; emavusertib; sx 862 |
| Journal Title: | Cancers |
| Volume: | 15 |
| Issue: | 8 |
| ISSN: | 2072-6694 |
| Publisher: | MDPI |
| Date Published: | 2023-04-02 |
| Start Page: | 2248 |
| Language: | English |
| DOI: | 10.3390/cancers15082248 |
| PROVIDER: | scopus |
| PMCID: | PMC10137017 |
| PUBMED: | 37190176 |
| DOI/URL: | |
| Notes: | Review -- Export Date: 1 June 2023 -- Source: Scopus |
