With regards to effectiveness, Cyclacel (Berkeley Heights, NJ) did not provide any leads to declare that it’s a lot better than azacitidine or decitabine. Inhibitors of Angiogenesis Lenalidomide Lenalidomide is currently used in the treating various hematological malignancies; the anticancer effects are likely due to several mechanisms. Preliminary information presented at the American Society of Hematology (ASH) annual meeting in ’09 showed that AML patients were responsive to lenalidomide in a nonspecific manner, indicating that patients didn’t of necessity have erasure 5q (del( 5q) lesions. Nevertheless, recent reports on SWOG S0605 in a phase II trial claimed that single-agent therapy with lenalidomide shown simple action (response rate: 14%) in older patients (60 years or older) with AML and del( 5q). Use of larger lenalidomide amounts in induction therapy will help overcome effects of additional chromosomal abnormalities. NCT01016600, beginning in January 2010, can be an open-label trial taking a look at lenalidomide + azacitidine in relapsed/refractory young AML or first-line older AML.68 DNA Methyl Transferase Inhibitors Dacogen and Vidaza The CR prices for the hypomethylating agents are below they’re with low-dose cytarabine. In first-line AML, the CR charge for Vidaza (Celgene) is 14%, while for low-dose cytarabine, it is 18%. Sorafenib selleck chemicals But many hematologists see the hypomethylating agencies as being more?au courant,? Therefore more individuals are utilizing them. In the community, more people are using Dacogen (SuperGen Inc., Dublin, CA) than Vidaza (Celgene) for AML because there is a perception that it is tougher than Vidaza (Celgene). Histone Deacetylase (HDAC) Inhibitors Vorinostat Vorinostat is a new anticancer agent inhibiting histone deacetylase and approved for treating cutaneous lymphoma. A phase II study of vorinostat in conjunction with cytarabine and idarubicin as front-line therapy for AML or MDS patients was reported. This combination was found to be safe, and overall response rates are extremely high with this combination, particularly in diploid and Flt-3 ITD individuals. Longer follow-up is required to measure the effect on survival. Studies specific for Flt-3?mutated patients and in conjunction with standard 7 + 3 treatment are ongoing.69 However, vorinostat as monotherapy proven minimal action in refractory Methotrexate and high-risk AML patients.70 Cytotoxics Amonafide L-malate (AS1413). Amonafide L-malate (amonafide, AS1413) is a special DNA intercalator. In a phase II study, 88 patients with secondary AML were enrolled to receive amonafide and Ara-C. General CR + CRi rate was 42%.