Drug classification for the treatment of hematologic malignancies

Abstract

The authors used the international classification of medications used in modern hematologic practice. The first attempt at using chemotherapy began with the introduction of deoxyribonucleic acid (DNA) alkylating drugs into clinical practice, along with antimetabolites and antitubulin agents, the activity of which was caused by mitotic band disruption and/or altered DNA replication. Despite the definite success achieved by DNAinteracting agents, they have typical myelotoxic dose-dependent effects that limit the possibility of treatment for many hematologic malignancies (HMs). An important event in onco-hematology is the development and use of targeted drugs, such as highly specific small molecules and monoclonal antibodies (mAbs) that inhibit molecular targets involved in the growth and spread of malignant cells, as antitumor agents in clinical practice. An important development in hematology for the treatment of HMs was the introduction of mAbs into clinical practice. Following the successful use of anti-CD20 (rituximab) therapy, various modifications, including the currently approved immunotoxin and one bispecific mAb, have been developed to improve the therapeutic efficacy of mAbs. The Food and Drug Administration approved the world’s first genetically modified chimeric antigen receptor T therapy in the past decade. Chimeric antigen receptor T-cells are significantly different from other anticancer drugs due to their ability to proliferate and expand. They can persist in the patient’s blood for months or even years and, for this reason, are called “live drugs.” Chimeric antigen receptor T-cells are the most promising type of anticancer therapy, especially for patients with relapsed or refractory HMs who do not respond to standard therapy. New medications are still being developed due to the need to reduce adverse effects and improve the management of HMs.