New drugs under development for acute lymphoblastic leukemia (ALL).
| New Agent . | Mechanism . | Notes . |
|---|---|---|
| Monoclonal Antibodies: | ||
| Rituximab | Anti-CD20 | May potentiate chemotherapy in B-cell malignancies |
| Alemtuzumab | Anti-CD52 | Can be given IV or subcutaneously |
| Antimetabolites: | ||
| Clofarabine | Nucleoside analog; inhibits ribonucleotide reductase and DNA polymerase | Approved for relapsed childhood ALL |
| Nelarabine | Pro-drug of ara-G. | Effective in T-ALL |
| Inhibits purine nucleoside phosphorylase (PNP). | ||
| Forodesine | Inhibits PNP | Under evaluation in T-ALL |
| Trimetrexate | Competitive inhibitor of dihydrofolate reductase | Not dependent upon facilitated transport into cells |
| Aminopterin | Anti-folate | Excellent oral bioavailability |
| Liposomal encapsulated drugs: | ||
| Liposomal vincristine | Diminished neurotoxicity | |
| Liposomal daunorubicin | Diminished cardiotoxicity | |
| Pegylated asparaginase | Long half-life (6 days) | |
| New Agent . | Mechanism . | Notes . |
|---|---|---|
| Monoclonal Antibodies: | ||
| Rituximab | Anti-CD20 | May potentiate chemotherapy in B-cell malignancies |
| Alemtuzumab | Anti-CD52 | Can be given IV or subcutaneously |
| Antimetabolites: | ||
| Clofarabine | Nucleoside analog; inhibits ribonucleotide reductase and DNA polymerase | Approved for relapsed childhood ALL |
| Nelarabine | Pro-drug of ara-G. | Effective in T-ALL |
| Inhibits purine nucleoside phosphorylase (PNP). | ||
| Forodesine | Inhibits PNP | Under evaluation in T-ALL |
| Trimetrexate | Competitive inhibitor of dihydrofolate reductase | Not dependent upon facilitated transport into cells |
| Aminopterin | Anti-folate | Excellent oral bioavailability |
| Liposomal encapsulated drugs: | ||
| Liposomal vincristine | Diminished neurotoxicity | |
| Liposomal daunorubicin | Diminished cardiotoxicity | |
| Pegylated asparaginase | Long half-life (6 days) | |