Table 6. Newer TKIs & non-TKIs under study for CML.
Agent | Mode of action | Activity in the presence of mutations/ Preliminary data |
Phase of development |
References |
---|---|---|---|---|
Omacetaxine mepesuccinate (Synribo) |
Semisynthetic formulation of homoharringtonine. The mechanism of action includes inhibition of protein synthesis leading to cell death. |
Not known/ CML-CP 18% MCR. |
Phase 3 | 71-74 |
MK 0457 | Aurora kinase inhibitor | T315I/ Minimal response in clinical trials |
Phase 2 | 75 |
PHA-739358 (Danusertib) |
Pan aurora kinase inhibitor and third generation TKI | T315I | Phase 2 | 45 |
ABL001 | Allosteric inhibitor of BCR-ABL prevents emergence of resistant disease when administered in combination with nilotinib |
Yes | Phase 1 | 48 |
DCC-2036 (Rebastinib) |
TIE2, VEGFR1, BCR-ABL kinase inhibitor | T315I | Phase 1 | 46,47 |
AT9283 | Aurora kinase inhibitor | Yes | Phase 1 | 76 |
BP5-087 | STAT3 SH2 domain inhibitor combines with bcr-abl1 inhibition to overcome kinase-independent resistance in chronic myeloid leukemia |
Yes | Pre-clinical | 77,78 |
ON012380 | Non-ATP competitive inhibitor of BCR-ABL | Unknown | Pre-clinical | 79 |
SGX70393 | Azapyridine-based inhibitor of native and T315I-mutant BCR-ABL kinase |
T315I | Pre-clinical | 80 |
TG101223 | Small molecule BCR-ABL inhibitor | T315I | Pre-clinical | 81 |
GNF-2/ GNF-5 | Allosteric inhibitors of BCR-ABL | T315I | Pre-clinical | 82 |
ESKM | Human IgG1 T-cell receptor mimic monoclonal antibody used alone or in combination with TKIs |
T315I | Pre-clinical | 83 |
U0126 | MEK1/2 inhibitor reverses imatinib resistance through down- regulating activation of Lyn/ERK signaling pathway in imatinib-resistant K562R leukemia cells |
Yes | Pre-clinical | 84 |
KW-2449 | Dual BCR-ABL Aurora kinase inhibitor | Yes | Pre-clinical | 85,86 |