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. 2021 Feb 13;13(4):784. doi: 10.3390/cancers13040784

Figure 1.

Figure 1

Principal targeted therapies available in MDS. Stylized pathways are also indicated. The arrow and connector style indicate the type of molecular effect. Majority of targeted drugs have an antagonist effect and work inhibiting a more or less specific enzymatic/proteic function. Exceptions are represented by erythropoietin stimulating agent (ESA) (agonists of Erythropoietin (EPO) receptor, not discussed here in detail) and APR-246, the new p53-mutated targeted agent, able to refold the aberrant protein restoring its transcriptional activity. For description of each mechanism of action see text. Figure created with BioRender. Abbreviations: SIRPα: Signal regulatory protein alpha; ESA: Erythropoietin stimulating agent; TGFβ: Transforming growth factor beta; IDH: Isocitrate dehydrogenase; HDAC(i): Histone deacetylases (inhibitor); Hh: Hedgehog polypeptides; PTCH: Protein patched homolog; SMO: Smoothened; HMA: Hypomethylating agents; DNMT: DNA methyl transferase; NAE: Neural Precursor Cell Expressed, Developmentally Down-Regulated 8 (NEDD8)-activating enzyme; GTP: guanosine triphosphate; GDP: Guanosine 5′-diphosphate; FLT3: FMS-like tyrosine kinase 3; PD-1: Programmed cell death 1; CTLA4: cytotoxic T-lymphocyte-associated protein 4; HIF: Fypoxia inducible factor; TERT: Telomerase reverse transcriptase; and TERC: Telomerase RNA component.