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Mechanisms of Resistance and Implications for Treatment Strategies in Chronic Myeloid Leukaemia
SIMPLE SUMMARY: Chronic myeloid leukaemia (CML) is a type of blood cancer that is currently well-managed with drugs that target cancer-causing proteins. However, a significant proportion of CML patients do not respond to those drug treatments or relapse when they stop those drugs because the cancer...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317051/ https://www.ncbi.nlm.nih.gov/pubmed/35884363 http://dx.doi.org/10.3390/cancers14143300 |
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author | Poudel, Govinda Tolland, Molly G. Hughes, Timothy P. Pagani, Ilaria S. |
author_facet | Poudel, Govinda Tolland, Molly G. Hughes, Timothy P. Pagani, Ilaria S. |
author_sort | Poudel, Govinda |
collection | PubMed |
description | SIMPLE SUMMARY: Chronic myeloid leukaemia (CML) is a type of blood cancer that is currently well-managed with drugs that target cancer-causing proteins. However, a significant proportion of CML patients do not respond to those drug treatments or relapse when they stop those drugs because the cancer cells in those patients stop relying on that protein and instead develop a new way to survive. Therefore, new treatment strategies may be necessary for those patients. In this review, we discuss those additional survival pathways and outline combination treatment strategies to increase responses and clinical outcomes, improving the lives of CML patients. ABSTRACT: Tyrosine kinase inhibitors (TKIs) have revolutionised the management of chronic myeloid leukaemia (CML), with the disease now having a five-year survival rate over 80%. The primary focus in the treatment of CML has been on improving the specificity and potency of TKIs to inhibit the activation of the BCR::ABL1 kinase and/or overcoming resistance driven by mutations in the BCR::ABL1 oncogene. However, this approach may be limited in a significant proportion of patients who develop TKI resistance despite the effective inhibition of BCR::ABL1. These patients may require novel therapeutic strategies that target both BCR::ABL1-dependent and BCR::ABL1-independent mechanisms of resistance. The combination treatment strategies that target alternative survival signalling, which may contribute towards BCR::ABL1-independent resistance, could be a successful strategy for eradicating residual leukaemic cells and consequently increasing the response rate in CML patients. |
format | Online Article Text |
id | pubmed-9317051 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93170512022-07-27 Mechanisms of Resistance and Implications for Treatment Strategies in Chronic Myeloid Leukaemia Poudel, Govinda Tolland, Molly G. Hughes, Timothy P. Pagani, Ilaria S. Cancers (Basel) Review SIMPLE SUMMARY: Chronic myeloid leukaemia (CML) is a type of blood cancer that is currently well-managed with drugs that target cancer-causing proteins. However, a significant proportion of CML patients do not respond to those drug treatments or relapse when they stop those drugs because the cancer cells in those patients stop relying on that protein and instead develop a new way to survive. Therefore, new treatment strategies may be necessary for those patients. In this review, we discuss those additional survival pathways and outline combination treatment strategies to increase responses and clinical outcomes, improving the lives of CML patients. ABSTRACT: Tyrosine kinase inhibitors (TKIs) have revolutionised the management of chronic myeloid leukaemia (CML), with the disease now having a five-year survival rate over 80%. The primary focus in the treatment of CML has been on improving the specificity and potency of TKIs to inhibit the activation of the BCR::ABL1 kinase and/or overcoming resistance driven by mutations in the BCR::ABL1 oncogene. However, this approach may be limited in a significant proportion of patients who develop TKI resistance despite the effective inhibition of BCR::ABL1. These patients may require novel therapeutic strategies that target both BCR::ABL1-dependent and BCR::ABL1-independent mechanisms of resistance. The combination treatment strategies that target alternative survival signalling, which may contribute towards BCR::ABL1-independent resistance, could be a successful strategy for eradicating residual leukaemic cells and consequently increasing the response rate in CML patients. MDPI 2022-07-06 /pmc/articles/PMC9317051/ /pubmed/35884363 http://dx.doi.org/10.3390/cancers14143300 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Poudel, Govinda Tolland, Molly G. Hughes, Timothy P. Pagani, Ilaria S. Mechanisms of Resistance and Implications for Treatment Strategies in Chronic Myeloid Leukaemia |
title | Mechanisms of Resistance and Implications for Treatment Strategies in Chronic Myeloid Leukaemia |
title_full | Mechanisms of Resistance and Implications for Treatment Strategies in Chronic Myeloid Leukaemia |
title_fullStr | Mechanisms of Resistance and Implications for Treatment Strategies in Chronic Myeloid Leukaemia |
title_full_unstemmed | Mechanisms of Resistance and Implications for Treatment Strategies in Chronic Myeloid Leukaemia |
title_short | Mechanisms of Resistance and Implications for Treatment Strategies in Chronic Myeloid Leukaemia |
title_sort | mechanisms of resistance and implications for treatment strategies in chronic myeloid leukaemia |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317051/ https://www.ncbi.nlm.nih.gov/pubmed/35884363 http://dx.doi.org/10.3390/cancers14143300 |
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