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The Treatment of Myeloid Malignancies with Kinase Inhibitors, An Issue of Hematology/Oncology Clinics of North America, E-Book

The Treatment of Myeloid Malignancies with Kinase Inhibitors, An Issue of Hematology/Oncology Clinics of North America, E-Book

Ann Mullally

(2017)

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Book Details

Abstract

This issue of Hematology/Oncology Clinics will focus on The Treatment of Myeloid Malignancies with Kinase Inhibitors. Articles will focus on: Targeting aberrant signaling in myeloid malignancies: promise versus reality; The development and use of imatinib for the treatment of chronic myelogenous leukemia; Mechanisms of resistance to ABL kinase inhibition in CML and the development of next generation ABL kinase inhibitors; Tyrosine kinase inhibitors in the treatment of systemic mastocytosis and hypereosinophilic syndrome; The development and use of JAK2 inhibitors for the treatment of myeloproliferative neoplasms (MPN); Mechanisms of resistance to JAK2 inhibitors in MPN; Kinase inhibitor screening in myeloid malignancies; and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
The Treatment of Myeloid Malignancies with Kinase Inhibitors\r i
Copyright\r ii
Contributors iii
CONSULTING EDITORS iii
EDITOR iii
AUTHORS iii
Contents v
Preface: Kinase Inhibitors in the Treatment of Myeloid Malignancies v
Targeting Aberrant Signaling in Myeloid Malignancies: Promise Versus Reality v
Tyrosine Kinase Inhibitor Treatment for Newly Diagnosed Chronic Myeloid Leukemia v
Mechanisms of Resistance to ABL Kinase Inhibition in Chronic Myeloid Leukemia and the Development of Next Generation ABL Ki ... v
The Development and Use of Janus Kinase 2 Inhibitors for the Treatment of Myeloproliferative Neoplasms vi
Mechanisms of Resistance to JAK2 Inhibitors in Myeloproliferative Neoplasms vi
Tyrosine Kinase Inhibitors in the Treatment of Eosinophilic Neoplasms and Systemic Mastocytosis vi
The Development of FLT3 Inhibitors in Acute Myeloid Leukemia vi
Mechanisms of Resistance to FLT3 Inhibitors and the Role of the Bone Marrow Microenvironment vii
Kinase Inhibitor Screening in Myeloid Malignancies vii
Identification and Targeting of Kinase Alterations in Histiocytic Neoplasms vii
HEMATOLOGY/ONCOLOGY\rCLINICS OF NORTH AMERICA\r\r viii
FORTHCOMING ISSUES viii
October 2017 viii
December 2017 viii
February 2018 viii
RECENT ISSUES viii
June 2017 viii
April 2017 viii
February 2017 viii
Preface:\rKinase Inhibitors in the Treatment of Myeloid Malignancies ix
Targeting Aberrant Signaling in Myeloid Malignancies 565
Key points 565
INTRODUCTION 565
WHAT MAKES A GOOD DRUG-TARGET PAIRING? 567
DRUGGING THE UNDRUGGABLE 567
ONCOGENE ADDICTION VERSUS DISEASE ACCELERATION 568
ON-TARGET TOXICITY AS A THERAPEUTIC LIABILITY 570
WHERE DO WE GO FROM HERE? 571
SUMMARY 572
REFERENCES 573
Tyrosine Kinase Inhibitor Treatment for Newly Diagnosed Chronic Myeloid Leukemia 577
Key points 577
INTRODUCTION: A SHORT HISTORY OF THE DEVELOPMENT OF TYROSINE KINASE INHIBITOR THERAPY 577
HOW TO DIAGNOSE CHRONIC MYELOID LEUKEMIA 579
CLINICAL AND PATHOLOGIC STAGING OF CHRONIC MYELOID LEUKEMIA 579
OUTCOME MEASURES WITH TYROSINE KINASE INHIBITOR TREATMENT OF CHRONIC MYELOID LEUKEMIA 579
MONITORING OF TREATMENT RESPONSE 580
INITIAL TYROSINE KINASE INHIBITOR THERAPY FOR CHRONIC PHASE CHRONIC MYELOID LEUKEMIA 581
CLINICALLY RELEVANT RESPONSE MILESTONES IN CHRONIC MYELOID LEUKEMIA TREATMENT 581
MUTATIONAL ANALYSIS FOR RESISTANCE/RELAPSE 582
SWITCHING TO A DIFFERENT TYROSINE KINASE INHIBITOR FOR RESISTANCE 582
TYROSINE KINASE INHIBITOR TOXICITY AND WHAT TO DO ABOUT IT 583
DISCONTINUATION OF TYROSINE KINASE INHIBITOR AFTER PROLONGED “DEEP” MOLECULAR RESPONSE 584
SUMMARY 585
REFERENCES 585
Mechanisms of Resistance to ABL Kinase Inhibition in Chronic Myeloid Leukemia and the Development of Next Generation ABL Ki ... 589
Key points 589
INTRODUCTION 590
DEFINITIONS 590
BCR-ABL1–Dependent Resistance 591
BCR-ABL1 kinase domain mutations 591
General considerations 591
Clinically observed BCR-ABL1 kinase domain mutations and structure–function relationships 592
Increased BCR-ABL1 expression 594
Drug influx/efflux pumps 596
Organic-cation transporter-1 596
Tyrosine kinase inhibitor bioavailability 596
BCR-ABL1–Independent Resistance 596
General considerations 596
STAT3 597
PI3K/AKT 597
RAF/MEK/ERK 597
Nucleocytoplasmic transport 600
EZH2 600
New Therapies 600
Tyrosine kinase inhibitors 600
ABL001 600
Drug combinations to eradicate leukemic stem cells and eliminate minimal residual disease 601
Tyrosine kinase inhibitors plus immune therapies 604
Tyrosine kinase inhibitors plus inhibitors of additional pathways 604
SUMMARY 605
REFERENCES 605
The Development and Use of Janus Kinase 2 Inhibitors for the Treatment of Myeloproliferative Neoplasms 613
Key points 613
INTRODUCTION 614
PRECLINICAL DEVELOPMENT OF JANUS KINASE INHIBITORS 615
CLINICAL DEVELOPMENT OF JANUS KINASE INHIBITORS 616
Ruxolitinib for Myelofibrosis 616
Ruxolitinib for Polycythemia Vera 617
Pacritinib 618
Momelotinib 620
NS-018 621
INCB-39100 621
JAK2V617F INHIBITORS 621
Targeting Janus Kinase-2 in the Inactive State 622
Targeting the Adenosine Triphosphate Binding Site in the Janus Kinase-2 Pseudokinase Domain 622
Targeting Allosteric Sites Specifically Involved in JAK2V617F Activation 622
Summary 622
ACKNOWLEDGMENTS 623
REFERENCES 623
Mechanisms of Resistance to JAK2 Inhibitors in Myeloproliferative Neoplasms 627
Key points 627
INTRODUCTION 627
RESISTANCE TO JAK2 INHIBITORS 629
Molecular Mechanisms of JAK2 Inhibitor Resistance 629
Genetic resistance 629
Functional resistance by persistence of JAK-STAT signaling 632
Functional resistance by protective cytokine effects 633
Intrinsic resistance in myelofibrosis 633
Clinical Aspects of JAK2 Inhibitor Resistance 633
APPROACHES TO OVERCOME RESISTANCE TO JAK2 INHIBITORS IN MYELOPROLIFERATIVE NEOPLASMS 634
Type I JAK2 Inhibitors 634
Heat Shock Protein 90 Inhibition 636
Type II JAK2 Inhibition 636
Combination Therapy Approaches 637
PI3K/Akt/Mammalian Target of Rapamycin Pathway 637
PIM Kinases 637
Bcl-2/Bcl-xL Inhibition 637
Pan-Histone Deacetylase Inhibitors 638
Additional Novel Concepts 638
REFERENCES 638
Tyrosine Kinase Inhibitors in the Treatment of Eosinophilic Neoplasms and Systemic Mastocytosis 643
Key points 643
INTRODUCTION 643
EOSINOPHILIC NEOPLASMS 644
Imatinib in Patients with PDGFRA/B Fusion Genes 644
FGFR1 Fusion Genes 647
Targeting the Janus Kinase/Signal Transducers and Activators of Transcription Pathway in Eosinophilic Neoplasms 649
FMS-like Tyrosine Kinase 3 Fusion Genes 649
SYSTEMIC MASTOCYTOSIS 650
Dasatinib and Nilotinib 650
Imatinib 650
Masitinib 651
Midostaurin 651
BLU-285 654
Targeting the Janus Kinase/Signal Transducers and Activators of Transcription Pathway in Systemic Mastocytosis 654
SUMMARY 655
REFERENCES 655
The Development of FLT3 Inhibitors in Acute Myeloid Leukemia 663
Key points 663
INTRODUCTION 663
FLT3 PATHWAY ACTIVATION IN ACUTE MYELOID LEUKEMIA 664
IMPACT OF FLT3 MUTATIONS ON PROGNOSIS 664
CHALLENGES TO TARGETING FLT3 664
CLINICAL EVALUATION OF FLT3 INHIBITORS 665
FLT3 INHIBITORS 665
First-Generation FLT3 Inhibitors 665
Lestaurtinib 665
Midostaurin 665
Sunitinib 670
Sorafenib 670
Second-Generation FLT3 Inhibitors 671
Quizartinib 671
Crenolanib 671
Gilteritinib 672
Summary of monotherapy with FLT3 inhibitors in acute myeloid leukemia 672
RELAPSED/REFRACTORY ACUTE MYELOID LEUKEMIA STUDIES WITH FLT3 INHIBITORS COMBINED WITH STANDARD THERAPIES 672
First-Generation FLT3 Inhibitors in Combination with Conventional Salvage Chemotherapy 672
Lestaurtinib 672
Sunitinib 673
Second-Generation FLT3 Inhibitors in Combination with Conventional Salvage Chemotherapy 673
TREATMENT-NAIVE ACUTE MYELOID LEUKEMIA STUDIES WITH FLT3 INHIBITORS IN COMBINATION WITH CONVENTIONAL CHEMOTHERAPY 673
Lestaurtinib 673
Sorafenib 673
Quizartinib 674
Midostaurin 674
Crenolanib 674
FLT3 INHIBITORS IN COMBINATION WITH HYPOMETHYLATING AGENTS 675
Summary of FLT3 Inhibitors in Combination with Standard Chemotherapy 675
ROLE FOR FLT3 INHIBITION AS MAINTENANCE THERAPY 675
SUMMARY 676
REFERENCES 676
Mechanisms of Resistance to FLT3 Inhibitors and the Role of the Bone Marrow Microenvironment 681
Key points 681
INTRODUCTION 681
ACUTE MYELOID LEUKEMIA CELLS DURING TREATMENT WITH FLT3 INHIBITORS 682
Bypassing the FLT3 Receptor 683
Suboptimal Pharmacokinetics and Pharmacodynamics 683
EMERGENCE OF RESISTANCE 685
Mutations in the Target Receptor 685
Activation of Alternative Signaling Pathways 685
STRATEGIES TO PREVENT THE DEVELOPMENT OF RESISTANCE OR TO SENSITIZE CELLS TO FLT3 INHIBITORS 687
TANDEM DUPLICATION ACUTE MYELOID LEUKEMIA 688
REFERENCES 688
Kinase Inhibitor Screening in Myeloid Malignancies 693
Key points 693
INTRODUCTION 693
KINASES AS GENE TARGETS IN MYELOID MALIGNANCY 693
Chromosomal Translocation 694
Point Mutations and Insertion/Deletions 694
Aberrant Expression 694
Oncorequisite Pathways 694
Microenvironment 695
FUNCTIONAL SCREENING AS A TOOL TO UNDERSTAND KINASE PATHWAY DYSREGULATION 695
Kinase Inhibitor Screening to Identify Pathway Dependence in Individual Patients 695
Cohort-Based Kinase Inhibitor Screening 696
Common Pathways/Drugs for Disease Subsets 696
Drug Repurposing 697
Kinase Inhibitor Screening to Refine Diagnostic and Therapeutic Markers 697
Application of Functional Kinase Inhibitor Screening in Lymphoid Malignancies 698
Drug Combinations 698
Beyond Kinase Inhibitors 699
SUMMARY 699
REFERENCES 699
Identification and Targeting of Kinase Alterations in Histiocytic Neoplasms 705
Key points 705
INTRODUCTION 705
SYSTEMIC HISTIOCYTIC NEOPLASMS AND THEIR CURRENT CLASSIFICATION 706
PROTOONCOGENE MUTATIONS IN HISTIOCYTOSES 706
DISCOVERY OF ADDITIONAL KINASE ALTERATIONS IN HISTIOCYTOSES 708
A-RAF Protooncogene 708
Mitogen-Activated Protein Kinase Kinase 1 708
Ras Isoforms 708
Phosphoinositide 3-Kinases Isoforms 709
Mitogen-Activated Protein Kinase Kinase Kinase 1 709
GENE FUSIONS 709
THERAPEUTIC EFFICACY OF KINASE INHIBITOR THERAPY IN HISTIOCYTOSES 710
RAF Inhibitors 711
MEK Inhibitors 714
Mammalian Target of Rapamycin Inhibitors 715
SUMMARY 715
REFERENCES 716