OXS-1550

In the more intensive re-induction British protocol (ALL-R3), Mitoxantrone and Idarubicin were compared, and it was observed that Mitoxantrone resulted in significant increases in both overall survival and progression-free survival rates due to the reduction of the relapse rate...Although the response rate was 44% in the phase 2 Clofarabine + Cyclophosphamide study performed in the previously intensively treated group, there was no benefit in the COG study containing Clofarabine + high dose Cytarabin (Ara-C) in the second or more recurrent ALL cases...The COG group demonstrated that the addition of Nelarabine to high-risk T-ALL treatment based on the BFM treatment scheme had an acceptable toxicity (mostly peripheral neuropathy) and observed an uneventful survival rate higher in the Nelarabine group...For example, liposomal vincristine has received FDA approval for the treatment of adult ALL. Some of the PEG binding molecules are already in use in daily practice (PEG-Asparaginase), while some have already been used in studies (PEGdoxorubicin)...Response rates increased to 73% with the addition of Bortezomib in children with precursor B (pB) cell ALL who had previously received intensive chemotherapy...The efficacy of Carfilzomib, a second generation proteosome inhibitor, is under investigation in phase 1-2 studies...In a phase 2 study in adult subjects, the combination of Decitabine and Vorinostat showed an acceptable toxicity and promising response rates, but the combination of these two drugs in a UK-ALL03-type re-induction in pediatric cases led to an unacceptable toxicity...Ruxolitinib studies are continuing in CRLF2, JAK/EPOR and JAK-STAT/MAPK subgroups and Dasatinib in ABL-class subgroup...mTOR inhibitors (Rapamycin, Evarolimus and Temsirolimus) are often used in combination with re-induction protocols for this pathway inhibition...The MEK inhibitor Selumetinib in this pathway has yielded active results in treatment in preclinical studies. The second-generation Flt3 inhibitor Quizartinib is being studied in patients with ALL. Since bcl-2 pathway prevents apoptosis, the efficacy of bcl-2 inhibitors, Navitoclax and Venetoclax, in ALL is being investigated...Palbociclib, CDK6 inhibitor, is used as monotherapy in KMT2A-r acute leukemia...Immunotherapy Antibody-based immunotherapy Blinatumomab: It is an antibody capable of binding to CD19 and CD3 and transmitting T-cell cytotoxicity to lymphoblasts presenting CD19...Denintuzumab mafodatin: It is a humanized CD19 antibody bound with monomethyl auristatin F (MMAF)...ADCT-402: It is a humanized anti-CD19 antibody conjugated with Pyrrolobenzodiazepine dimer cytotoxin...DT2219: It is a bispecific, recombinant, diphtheria toxin-based immunotoxin that recognizes CD19 and CD22-presenting cells...Inotuzumab ozogamicin: It is a novel monoclonal antibody against CD22 conjugated to the toxin Calicheamicin...Epratuzumab: It is a humanized monoclonal anti-CD22 antibody...Rituximab: It is a chimeric monoclonal CD20 antibody...Ofatumumab: It is a humanized anti-CD20 antibody...Obinutuzumab: It a type II humanized anti-CD20 monoclonal antibody...Etanercept (anti-TNF) and Tociluzumab (anti IL-6) can be used in the treatment of cytokine release syndrome. There are many marching studies on CAR-T cell therapy.