AML patients are treated with chemotherapy as well as more recent targeted treatments. The best drug for you will depend on the particulars of your cancer, as there are several possibilities.
Your bone marrow produces aberrant platelets and blood cells when you have acute myeloid leukemia (AML), a blood malignancy. It’s the most prevalent type of adult acute leukemia, meaning it develops quickly and needs to be treated right once.
There are numerous AML therapy choices available. When choosing the best course of action for you, your medical team will carefully assess several criteria, including the type of AML you have and if the malignancy has spread. First-line treatment is usually medication.
Learn more about the pharmaceuticals used by doctors to treat AML by reading on. These medications include targeted therapies and chemotherapy pills.
Chemotherapy for acute myeloid leukemia
A family of medications known as “chemotherapy” works by either directly destroying cancer cells or inflicting enough damage on them to prevent them from proliferating and developing into new malignant cells. Chemotherapy is known to have side effects, including infections, nausea, and hair loss, despite its effectiveness.
According to experts, after receiving chemotherapy as an induction therapy for newly diagnosed AML, two out of every three patients experience remission.
The following options are frequently employed in the systemic treatment of AML:
- decitabine (Dacogen)
- idarubicin (Idamycin)
- azacitidine (Onureg, Vidaza)
- cytosine arabinoside (cytarabine)
- daunorubicin (Cerubidine)
- mitoxantrone (Novantrone)
- methotrexate (Trexall, Xatmep) for combination therapy only
Doctors may occasionally additionally take into account combination medications, such as:
- daunorubicin and cytarabine liposome (Vyxeos)
- cytarabine and methotrexate
Whether your cancer has migrated to your central nervous system (CNS) will determine how medical experts treat your AML. If it has, chemotherapy is administered straight into the cerebrospinal fluid, which surrounds your brain and spinal cord. Another name for this procedure is intrathecal chemotherapy.
The doctor may suggest systemic chemotherapy if the cancer has not progressed to the central nervous system. This is given as an injection or by mouth.
To secure the production of new, healthy blood cells that these cancer medications may otherwise damage, doctors occasionally combine chemotherapy with a stem cell transplant.
Targeted therapy for acute myeloid leukemia
Because they can target particular genes and the proteins they produce that contribute to the progression of cancer, targeted treatments are among the AML therapy approaches that have been studied the most.
Although the degree and frequency of side effects vary from person to person, many medications can also produce them. Though there are other reasons such as infections, edema, and more, skin changes are the most common.
Your oncologist will perform testing to determine whether you have a genetic mutation before starting these medications.
For AML patients, doctors may combine or substitute the following targeted therapy with chemotherapy:
FLT3 inhibitors
FLT3 inhibitors focus on FLT3 gene mutations, which can occasionally be a factor in cancer. As an example, consider:
- quizartinib (Vanflyta)
- gilteritinib (Xospata)
- midostaurin (Rydapt)
Typically, you would take them 1 or 2 times per day.
IDH inhibitors
Excess proteins linked to genetic mutations affecting the IDH1 or IDH2 genes are blocked by IDH inhibitors. IDH inhibitors, in contrast to other targeted medicines, can aid in the direct transformation of immature leukemia blood cells into normal, healthy ones.
Currently, licensed IDH inhibitors for the treatment of AML include:
- ivosidenib (Tibsovo)
- enasidenib (Idhifa)
- olutasidenib (Rezlidhia)
You take these by mouth 1 to 2 times per day.
BCL-2 inhibitors
The corresponding cellular proteins are the target of BCL-2 inhibitors. Physicians typically recommend these medications to persons over 75 who are diagnosed with AML for the first time.
Venetoclax (Venclexta) is the only BCL-2 inhibitor that is currently approved for the treatment of AML.
This medication is used orally once a day.
Hedgehog pathway inhibitors
Hedgehog pathway inhibitors are typically prescribed by physicians to patients 75 years of age or older, much like BCL-2 inhibitors.
A crucial step in the process of a stem cell differentiating into a certain kind of cell is the hedgehog signaling pathway. Certain malignancies, such as leukemia, can result from this pathway being overactivated.
Glasdegib (Daurismo) is the sole approved medication for AML in this class at the moment. Those who are or may become pregnant shouldn’t do it.
You take these medicines every day as well.
Monoclonal antibodies
Proteins produced in laboratories assist monoclonal antibodies in their targeting of cells. Many monoclonal antibodies treat different diseases and long-term problems, but only one is approved for AML at this time: gemtuzumab ozogamicin (Mylotarg).
To function, mylotarg binds to CD33 proteins found inside AML cells. It can enhance the effects of chemotherapy, working in concert with it.
Mylotarg is administered intravenously (IV) by medical personnel, in contrast to other targeted therapy for AML.
Medications for acute promyelocytic leukemia (APL)
An aggressive subtype of AML is called APL. To prevent the progression of this particular type of leukemia, a medical practitioner may suggest the following cancer medications:
All trans-retinoid acid (ATRA)
ATRA is an ingredient that comes from vitamin A. By perhaps eliminating cancer cells and stopping them from proliferating, ATRA may be used to treat APL. You ingest this medication orally.
Arsenic trioxide (ATO)
When the PML-RARA gene is involved in APL, clinicians may prescribe the injectable drug Trisenox as part of the ATO treatment. It functions by eliminating the gene’s proteins, which can then aid in the destruction of leukemia cancer cells.
If APL hasn’t improved or has returned after trying previous AML treatment options, doctors might suggest Trisenox.
Takeaway
AML is a kind of leukemia that is aggressive, particularly if treatment is delayed. This malignancy has a wide range of treatments, and researchers are always looking for new treatments.
Discuss your drug choices with a medical expert to find out how they might fit into your overall plan of therapy for AML.
FAQs
What drugs are used to treat AML?
Two chemotherapy medications used as intrathecal chemotherapy to treat AML include methotrexate and cyclosporine. These medications can also be administered systemically.
What is the best treatment for AML?
Most AML types are treated primarily with chemotherapy, perhaps in conjunction with a medication known as targeted therapy. There may be a stem cell transplant after this.
What is the new drug treatment for acute myeloid leukemia?
AML cells with this gene alteration are the focus of medications known as FLT3 inhibitors. FLT3 inhibitors are currently authorized for the treatment of patients whose AML cells carry an FLT3 mutation, including gilteritinib (Xospata), quizartinib (Vanflyta), and midostaurin (Rydapt). Currently, a number of other FLT3 inhibitors are being investigated.