The New Challenge of Curing AML: Analysis of Mechanisms of Resistance of Target Drugs and Future Perspectives

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Tumor Microenvironment".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 441

Special Issue Editor


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Guest Editor
Departement of Haematology, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Via Conca 71, 60126 Ancona, Italy
Interests: acute myeloid leukemia; hemopoietic stem cell transplant; target therapy; mechanisms of resistance; minimal residual disease

Special Issue Information

Dear Colleagues,

The advent of new target drugs for use in treatment has improved the prognosis of AML without changing the indications for allogeneic transplantation. Only 30% of patients with adverse- and intermediate-risk AML survive in the long term. On this basis, understanding the mechanisms behind resistance is critical to treating AML. Identifying molecular mutations that emerge after treatment with target drugs can help to select new targets and their inhibitors. LSCs still represent the major unmet medical need in resistant and refractory disease. Analysis of the metabolism of LSCs and their resistance to target drugs also represents a potential attempt to identify targets for the eradication of minimal residual disease. Inhibitors of FLT3, IDH1-2, and BCL-2, as well as immunotherapies such as monoclonal antibodies, CART, and anti-PD1/PD-L1, should be analyzed in terms of escape mechanisms and future prospects.

We are pleased to invite authors in this field to write reviews discussing the mechanisms of resistance of new target drugs in AML. We will also accept original research articles analyzing the in vivo and in vitro resistance mechanisms of target drugs or escape mechanisms of LSCs and stroma, as well as articles reviewing currently available immunotherapies and immunological escape mechanisms. Discussions of target drugs, pharmacological characteristics and drug interactions with dosage adjustments are also welcome. Finally, there is a need to discuss the prospects of new drugs, currently under investigation, that can be used to overcome resistance.

I look forward to receiving your contributions.

Dr. Debora Capelli
Guest Editor

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Keywords

  • AML
  • FLT3 inhibitors
  • BCL2 inhibitor
  • MCL1
  • IDH1-2 inhibitors
  • venetoclax
  • CAR-T
  • anti-CD123 monoclonal antibodies
  • anti-CD33 monoclonal antibodies
  • anti-PD-1 and -PD-L1

Published Papers (1 paper)

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Review

17 pages, 2213 KiB  
Review
FLT3-Mutated Leukemic Stem Cells: Mechanisms of Resistance and New Therapeutic Targets
by Debora Capelli
Cancers 2024, 16(10), 1819; https://doi.org/10.3390/cancers16101819 - 10 May 2024
Viewed by 326
Abstract
Despite the availability of target drugs in the first and second line, only 30% of FLT3mut AMLs are cured. Among the multiple mechanisms of resistance, those of FLT3mut LSC are the most difficult to eradicate because of their metabolic and genomic characteristics. Reactivation [...] Read more.
Despite the availability of target drugs in the first and second line, only 30% of FLT3mut AMLs are cured. Among the multiple mechanisms of resistance, those of FLT3mut LSC are the most difficult to eradicate because of their metabolic and genomic characteristics. Reactivation of glycogen synthesis, inhibition of the RAS/MAPK pathway, and degradation of FLT3 may be potential aids to fight the resistance of LSC to FLT3i. LSC is also characterized by the expression of a CD34+/CD25+/CD123+/CD99+ immunophenotype. The receptor and ligand of FLT3, the natural killer group 2 member D ligand (NKGD2L), and CD123 are some of the targets of chimeric antigen receptor T cells (CAR-T), bispecific T-cell engager molecules (BiTEs), CAR-NK and nanoparticles recently designed and reported here. The combination of these new therapeutic options, hopefully in a minimal residual disease (MRD)-driven approach, could provide the future answer to the challenge of treating FLT3mut AML. Full article
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