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ATRA plus 6-MP and MTX
This combination uses ATRA to differentiate leukemic cells while 6-MP and MTX provide cytotoxic chemotherapy to eliminate rapidly dividing cancer cells.
This combination uses ATRA to differentiate leukemic cells while 6-MP and MTX provide cytotoxic chemotherapy to eliminate rapidly dividing cancer cells. Used for Acute promyelocytic leukemia (APL), Acute myeloid leukemia (AML).
At a glance
| Generic name | ATRA plus 6-MP and MTX |
|---|---|
| Also known as | Arm B |
| Sponsor | Wyeth is now a wholly owned subsidiary of Pfizer |
| Drug class | Retinoid plus antimetabolite chemotherapy combination |
| Target | PML-RARA fusion protein (ATRA); DHFR and TPMT (MTX and 6-MP) |
| Modality | Small molecule |
| Therapeutic area | Oncology |
| Phase | Phase 3 |
Mechanism of action
ATRA (all-trans retinoic acid) induces differentiation of acute promyelocytic leukemia (APL) cells, particularly those with t(15;17) translocations, promoting maturation and apoptosis. 6-MP (6-mercaptopurine) and MTX (methotrexate) are antimetabolites that inhibit nucleotide synthesis and cell proliferation, providing additional cytotoxic activity. The combination leverages differentiation therapy with conventional chemotherapy for enhanced efficacy in hematologic malignancies.
Approved indications
- Acute promyelocytic leukemia (APL)
- Acute myeloid leukemia (AML)
Common side effects
- Myelosuppression (neutropenia, thrombocytopenia)
- Mucositis
- Hepatotoxicity
- Nausea and vomiting
- Differentiation syndrome (ATRA syndrome)
- Infection
Key clinical trials
- Study for Patients With Newly Diagnosed, High-risk Acute Promyelocytic Leukemia (PHASE3)
- Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Acute Promyelocytic Leukemia (PHASE3)
- Phase III Trial in Acute Promyelocytic Leukemia Patients (PHASE3)
- Tretinoin, Cytarabine, and Daunorubicin Hydrochloride With or Without Arsenic Trioxide Followed by Tretinoin With or Without Mercaptopurine and Methotrexate in Treating Patients With Acute Promyelocytic Leukemia (PHASE3)
- Comparison of Two Treatments in Intermediate and High-risk Acute Promyelocytic Leukemia (APL) Patients to Assess Efficacy in 1st Hematological Complete Remission and Molecular Remission (PHASE3)
Primary sources
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| Source | Used for |
|---|---|
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |