Early stage clinical trials are examining the safety and effectiveness of numerous drugs either as individual agents or in combination with standard treatment for patients with AML. For example, the hypomethylating agents azacitidine and decitabine have already been used in the environment of relapsed or refractory leukemia with conjugating enzyme limited information to support this method. 60 C63 Here, we shall briefly review a number of the knowledge. Clofarabine Clofarabine is really a second generation nucleoside analogue recently demonstrated to have efficacy in relapsed and refractory AML. In a phase II trial in patients with relapsed or refractory leukemias, 48-hour response rate was observed to single agent clofarabine given at a dose of 40 mg/m2 daily for 5 days. 64 A subsequent section I II study examined the efficacy of the combination of clofarabine in combination with Ara C similarly found an answer rate of 38-year with the toxicities limited by grade 2 including nausea/vomiting, allergy and mucositis. 65 The CLASSIC I trial was a phase III prospective randomized trial evaluating clofarabine/Ara C versus Ara C alone in 320 patients ages 55 and older with relapsed/refractory AML. Results were presented in abstract form in the meeting of the American Society of Clinical Oncology. The main endpoint was overall survival, and overall survival was Retroperitoneal lymph node dissection perhaps not different between both hands. Statistically significant differences favoring the combination were observed in CR rate for relapsed patients. 66 These results have led to the usage of clofarabine/Ara C for relapsed patients with AML as a bridge to transplantation. In addition, clofarabine was examined in conjunction with Ara C and granulocyte colony-stimulating factor in a stage I/II study. Clofarabine was handed at 25 mg/m2/day 5 days, Ara C at 2 g/m2/day 5 days, and G CSF at 5 g/kg starting the afternoon before chemotherapy and continuing until neutrophil recovery. ALK inhibitor The CR/CRi price was 61-point and responses were seen across all cytogenetic risk groups. Ongoing clinical trials are looking at clofarabine in combination with different agents including gemtuzumab and sorafenib, among others. 23 FLT3 inhibitors The identification of the FLT3 ITD mutation as a sign of poor prognosis in AML was quickly matched with the requirement that inhibitors of mutant FLT3 could lead to improved outcomes for patients. A comprehensive review of of the FLT3 inhibitors tested in clinical studies thus far is beyond the scope of the review, and the reader is described references 67 and 68 for further details. 67, 68 Here we’ll shortly summarize the difficulties and scientific development of incorporating FLT3 inhibitors into AML therapy. FLT3 ITD versions are associated with a 5-year survival rate of 15-payline and are present in as much as 25 percent of patients with AML. Its AML classification schema was revised by the WHO in 2008 to include FLT3 mutant AML as a distinct entity with poor prognosis. Provided its prevalence among patients with AML and high rates of relapse, there is an unmet need to specifically target this subset of AML.