TP53-mutated acute myeloid leukemia and myelodysplastic syndrome : biology, treatment challenges, and upcoming approaches

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..

Improved understanding of TP53 biology and the clinicopathological features of TP53-mutated myeloid neoplasms has led to the recognition of TP53-mutated acute myeloid leukemia/myelodysplastic syndrome (TP53m AML/MDS) as a unique entity, characterized by dismal outcomes following conventional therapies. Several clinical trials have investigated combinations of emerging therapies for these patients with the poorest molecular prognosis among myeloid neoplasms. Although some emerging therapies have shown improvement in overall response rates, this has not translated into better overall survival, hence the notion that p53 remains an elusive target. New therapeutic strategies, including novel targeted therapies, immune checkpoint inhibitors, and monoclonal antibodies, represent a shift away from cytotoxic and hypomethylating-based therapies, towards approaches combining non-immune and novel immune therapeutic strategies. The triple combination of azacitidine and venetoclax with either magrolimab or eprenetapopt have demonstrated safety in early trials, with phase III trials currently underway, and promising interim clinical results. This review compiles background on TP53 biology, available and emerging therapies along with their mechanisms of action for the TP53m disease entity, current treatment challenges, and recently published data and status of ongoing clinical trials for TP53m AML/MDS.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:103

Enthalten in:

Annals of hematology - 103(2024), 4 vom: 28. März, Seite 1049-1067

Sprache:

Englisch

Beteiligte Personen:

Pereira, Mariana Pinto [VerfasserIn]
Herrity, Elizabeth [VerfasserIn]
Kim, Dennis D H [VerfasserIn]

Links:

Volltext

Themen:

Acute myeloid leukemia
Azacitidine
Journal Article
M801H13NRU
Myelodysplastic syndrome
P53 biology
Review
TP53 mutation
TP53 protein, human
Tumor Suppressor Protein p53

Anmerkungen:

Date Completed 15.03.2024

Date Revised 27.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00277-023-05462-5

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM36266837X