Update on developmental therapeutics for acute lymphoblastic leukemia.

This is an exciting time in drug development for acute lymphoblastic leukemia (ALL). A confluence of trends makes it likely that highly effective new agents for ALL will be identified in the coming decade. One contributory factor is the development of more representative preclinical models of ALL for testing and prioritizing novel agents. Another important trend in ALL drug development is the increasing understanding at the molecular level of the genomic changes that occur in B-precursor and T-cell ALL. A final important trend is the increasing availability of new agents against relevant molecular targets. Molecularly targeted agents of interest discussed in this review include novel antibody-based drugs targeted against leukemia surface antigens, proteasome inhibitors, mTOR inhibitors, JAK inhibitors, Aurora A kinase inhibitors, and inhibitors of Bcl-2 family proteins.