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Leukemias
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
While qualified responses with TKIs have been observed in patients with CML in AP, most tend not to be durable.69,88 The activity of TKIs in BT is even less impressive with a median survival of less than 9 months. Currently, dasatinib and bosutinib are licensed for BT; another approved drug is omacetaxine mepesuccinate, an inhibitor of protein synthesis. In younger patients, it might be reasonable to offer patients in BT intensive chemotherapy in combination with aKD mutation and prior therapy-guided TKI and consider allo-SCT if a second CP is achieved.
Chronic Myeloid Leukaemia
Published in Tariq I. Mughal, Precision Haematological Cancer Medicine, 2018
Whilst qualified responses with TKIs have been observed in patients with CML in the accelerated phase, most tend not to be durable. The activity of TKIs in BT is even less impressive with a median survival of less than 9 months. Currently, both dasatinib and bosutinib, but not nilotinib are licensed for BT. Another useful drug licensed for CP and accelerated phase disease-resistant to at least two TKIs, is omacetaxine mepesuccinate, an inhibitor of protein synthesis. The drug is often associated with severe myelosuppression, which has limited its use. In younger patients, it might be reasonable to offer patients in frank BT, and an acute leukaemia type of chemotherapy in combination with a TKI which they might not have received prior to BT, or an appropriate clinical trial assessing one of the newer drugs and then consider allo-SCT if a second CP is achieved. At present, the MD Anderson Hospital (Houston) has a TKI plus hypomethylating agent trial underway that looks promising, but clearly, it is difficult to make firm recommendations at present. Lastly, a report from Peter Valent (Vienna) of the use of a rotation of ponatinib and bosutinib, to induce persistent deep MR in an older patient with multi-resistant blast crisis, is interesting and merits further study.
The effects of anticancer medicinal herbs on vascular endothelial growth factor based on pharmacological aspects: a review study
Published in Nutrition and Cancer, 2021
Sajad Fakhri, Fatemeh Abbaszadeh, Masoumeh Jorjani, Mohammad Hossein Pourgholami
As alkaloids isolated from Cephalotaxus harringtonia var. drupacea (Cephalotaxaceae family), Homoharringtonine (HHT) have shown to be promising antiangiogenic agents. HHT showed beneficial effects in chronic myeloid leukemia (CML) following the failure of treatment with interferon-α. Earlier results seem to support the use of HHT for patients with Imatinib-resistant CML (53). In general, the antitumor activity of HHTs is done through the inhibition of protein synthesis and the promotion of apoptosis (85). The results of Xiu-jin et al. research showed HHT-induced apoptosis in endothelium and down-regulated VEGF expression in K562 cells. They speculated that HHT also exerted its anti-leukemia effects via the reduction of angiogenesis (86). HHT also blocked VEGFR and induced apoptosis through IL-6/JAK1/STAT3 signal pathway (87), which confirms the potential of HHT to combat angiogenesis in cancer. Further, semi-synthetic drugs of HHT group Omacetaxine mepesuccinate is a subcutaneously.