arsenic trioxide / Generic mfg. - LARVOL DELTA

PML::RARα+ myeloid cells display metabolic alterations that can be targeted to treat resistant/relapse acute promyelocytic leukemias. (PubMed, Leukemia) - "All-trans retinoic acid (ATRA) and arsenic trioxide (ATO)-based therapies render APL the most curable subtype of AML, yet approximately 1% of cases are resistant and 5% relapse...Notably, our data demonstrate that glycolytic impairment via AKT inhibition by PML::RARα renders APL cells reliant on OXPHOS. This dependency confers high sensitivity to the VTX-AZA combination, suggesting the therapeutic efficacy of targeted combination treatment in resistant or relapsed APLs."

Journal • Acute Myelogenous Leukemia • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Metabolic Disorders • Oncology • CD34 • CD36 • RARA • SCARB1

Overcoming resistance in RET-altered cancers through rational inhibitor design and combination therapies. (PubMed, Bioorg Chem) - "Traditional multi-kinase inhibitors (MKIs, such as cabozantinib and vandetanib) exhibit significant side effects due to non-selective inhibition of targets like VEGFR, and also suffer from resistance associated with RET mutations (e.g., V804L/M, G810C/S/R), both of which limit their clinical application...To overcome drug resistance, the design strategies of novel inhibitors focus on multi-target inhibition (such as PLM-101 targeting RET/YES1/FLT3, TPX-0046 targeting RET/SRC), structural optimization (such as helical ring derivatives enhancing binding stability), and natural compound screening (such as ZINC series molecules)...For instance, selpercatinib combined with crizotinib can inhibit MET amplification-driven resistance, while arsenic trioxide combined with pralsetinib restores sensitivity by inhibiting the HH-Gli pathway. Current clinical trials show that novel RET inhibitors such as SY-5007 have a significant objective response rate in advanced RET..."

Journal • Review • Lung Cancer • Non Small Cell Lung Cancer • Oncology • Solid Tumor • FGFR • FLT3 • MET • RET • STAT1

Association of Early Chemotherapy With Reduced In-Hospital Mortality and Complications in Acute Promyelocytic Leukemia: Insights From a Nationwide Cohort (SOHO 2025) - "Early initiation of chemotherapy, such as with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO), has been associated with favorable outcomes... Early chemotherapy was associated with lower rates of DIC, sepsis (presumably from lower rates of neutropenia), and mortality despite similar demographics and comorbidity burden. These findings support immediate initiation of ATRA, ATO, or other therapies upon presentation to reduce morbidity and mortality in APML."

Clinical • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology

APOLLO: Optimizing the Treatment of High-Risk Acute Promyelocytic Leukemia With All-Trans Retinoic Acid and Arsenic Trioxide While Minimizing the Role of Chemotherapy. (PubMed, J Clin Oncol) - No abstract available

Journal • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology

Role of eIF4E in mediating cytotoxic effect of HHT and ATO on AML cells in bone marrow microenvironment. (PubMed, Hematology) - "We established the stromal-AML co-culture system (HS-5 cells with U937, HL-60, and primary AML cells) and the humanized mouse AML model to systematically evaluate eIF4E's role in modulating homoharringtonine (HHT) and arsenic trioxide (ATO) cytotoxicity within the leukemic microenvironment. Genetic perturbation studies demonstrated that eIF4E knockdown sensitized AML cells to HHT/ATO, whereas its overexpression conferred therapeutic resistance. eIF4E may play an essential role in mediating the cytotoxic effects of HHT and ATO, representing a novel therapeutic target in AML."

Journal • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Oncology • EIF4E • EIF4EBP1 • MCL1

Paxillin promotes the invasion and migration of polyploid giant cancer cells with daughter cells after arsenic trioxide treatment by regulating the expression of cathepsin B/D. (PubMed, J Cancer) - " Paxillin phosphorylation plays an important role in PDCs invasion and migration. Paxillin may be a potential predictor of metastasis and an independent prognostic factor for recurrence and may target phosphorylation to mitigate the impact of chemotherapy-resistant cells on cancer progression, thereby improving patient outcomes."

Journal • Colorectal Cancer • Oncology • Solid Tumor • CDC42 • CTSB

A Rare Case of Visual Hallucination Due to Arsenic Trioxide in Acute Promyelocytic Leukemia (SOHO 2025) - "This case report creates awareness about the rare side effect of visual hallucinations in patients with APML treated with ATO."

Clinical • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology • PML

Real-World Outcomes of Acute Promyelocytic Leukemia Treatment in a Resource-Constrained Setting: A Single-Center Experience From Nepal (SOHO 2025) - "Background: Acute promyelocytic leukemia (APL) is highly curable with remarkable sensitivity to all-trans retinoic acid (ATRA) and arsenic trioxide (ATO)...LR patients received ATO plus ATRA per the Intergroup APL0406 protocol, whereas HR patients received ATRA, daunorubicin, and ATO per the North American Leukemia Intergroup Study, with omission of cytarabine during induction... Early diagnosis and timely access to treatment are critical for optimizing outcomes in APL, particularly in LMICs. Generic ATO offers a cost-effective solution to improve outcomes in resource-limited settings, addressing global disparities in APL management."

Clinical • Real-world • Real-world evidence • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology

Arsenic trioxide for reprogramming the bone marrow microenvironment to eliminate acute myeloid leukemia blasts. (PubMed, Hemasphere) - No abstract available

Journal • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Oncology

BCOR-RARA Variant APL: A Diagnostic Challenge and Therapeutic Success With ATRA/ATO (SOHO 2025) - "Introduction: Classic acute promyelocytic leukemia (APL) is driven by PML-RARA fusion and cured with all-trans-retinoic acid (ATRA) plus arsenic trioxide (ATO)... Negative PML-RARA testing does not exclude APL. Molecular diagnostics allow recognition of rare variants, such as BCOR-RARA, and timely ATRA therapy is capable of durable remission."

Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology • BCOR

All-Trans Retinoic Acid and Arsenic Trioxide versus All-Trans Retinoic Acid and Chemotherapy in Acute Promyelocytic Leukemia: A Meta-Analysis of Randomized Controlled Trials (SOHO 2025) - "Searches were conducted in PubMed, Web of Science, Scopus, and Cochrane Library for randomized controlled trials (RCTs) comparing ATRA+ATO with ATRA+CT in adult APL patients. ATRA+ATO demonstrates superior efficacy compared with ATRA+CT in adult APL patients, with improved survival outcomes and reduced hematologic toxicity, despite increased hepatotoxicity. These findings support ATRA+ATO as the preferred first-line therapy in this setting."

Retrospective data • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology

Meta-Analysis of Oral Versus Intravenous Arsenic in Acute Promyelocytic Leukemia: Treatment Effectiveness and Safety Profile (SOHO 2025) - "For non-high-risk APL, intravenous arsenic trioxide (ATO) plus all-trans-retinoic acid (ATRA) is the standard treatment... Oral arsenic (RIF) appears as effective as intravenous ATO in non-high-risk APL, with a favorable safety profile and potential for reduced toxicity, supporting its use as a viable alternative treatment."

Retrospective data • Acute Myelogenous Leukemia • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology

Oxidative stress induces cortical stiffening and cytoskeletal remodelling in pre-apoptotic cancer cells. (PubMed, Cell Stress) - "Using atomic force microscopy and flow cytometry, we demonstrate this effect across multiple ROS inducers: the combination of arsenic trioxide and D-enantiomer of vitamin C, hydrogen peroxide, and rotenone. These findings explain previously debated relationships on how ROS influence actin organization, which may affect cellular stiffness. By separating total from cortical actin effects, our study reveals a redox-sensitive mechanism that governs cytoskeletal remodelling and may impair cancer cell migration."

Journal • Oncology • Pancreatic Cancer • Solid Tumor

Impact of in vitro exposure to 5G-modulated 3.5 GHz fields on oxidative stress and DNA repair in skin cells. (PubMed, Sci Rep) - "Using genetically encoded Bioluminescence Resonance Energy Transfer (BRET)-based biosensors targeted to the cytoplasm and mitochondria, we assessed whether exposure of human fibroblasts to 5G RF-EMF at specific absorption rates (SAR) of 0.08 and 4 W/kg for 24 h could alter basal reactive oxygen species (ROS) levels or potentiate the effects of known ROS inducers, including H₂O₂, Kp372-1, and Antimycin A. We also evaluated whether pre-exposure to 5G RF-EMF could induce an adaptive response (AR), by modulating ROS production following a subsequent challenge with arsenic trioxide (As₂O₃)...Likewise, RF-EMF exposure did not induce an adaptive response to oxidative challenge, nor did it alter the kinetics or the efficiency of CPD repair by the nucleotide excision repair (NER) pathway. These findings support the conclusion that the exposure to 5G RF-EMF at 3.5 GHz up to 4 W/kg does not induce oxidative stress or impair DNA repair efficiency in human skin cells,..."

Journal • Preclinical

MALNC: a new mutant NPM1/IDH2R140 and PML-RARA-associated lncRNA with impact on AML cell proliferation, maturation and drug response. (PubMed, Cancer Gene Ther) - "Functional studies showed that MALNC knockout impairs AML cell proliferation and colony formation, enhances ATRA-induced differentiation, and sensitizes cells to arsenic trioxide. Transcriptomic analysis revealed that MALNC loss alters the expression of retinoic acid pathway genes, and chromatin binding studies showed that MALNC binds to genes related to the retinoic acid and Rho GTPase pathways. In conclusion, we have identified MALNC as a novel lncRNA that promotes leukemic cell proliferation, counteracts ATRA-induced differentiation, and modulates drug sensitivity in AML."

Journal • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Oncology • NPM1 • PML

Arsenic Trioxide and All-Trans Retinoic Acid Combination Therapy for the Treatment of High-Risk Acute Promyelocytic Leukemia: Results From the APOLLO Trial. (PubMed, J Clin Oncol) - P3 | "The results of the APOLLO trial support the use of ATO and ATRA for the treatment of newly diagnosed patients with high-risk APL."

Journal • Acute Promyelocytic Leukemia • Hematological Malignancies • Infectious Disease • Leukemia • Novel Coronavirus Disease • Oncology

Guillain-Barre Syndrome: A Rare Neurotoxicity Following Arsenic Trioxide and All-Trans Retinoic Acid Treatment in a Patient With Acute Promyelocytic Leukemia (SOHO 2025) - "The patient was induced with ATO and ATRA, which were continued for 8 weeks. GBS should be recognized as a severe neurological complication of induction therapy for APL. Patients may receive low-dose ATRA and ATO without neurological complications."

Clinical • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology

Small-Molecule-Induced Protein Polymerization: Mechanisms and Therapeutic Implications. (PubMed, Biomol Ther (Seoul)) - "This review provides a comprehensive overview of five such molecules: arsenic trioxide (As2O3), BI-3802, NVS-STG2, paclitaxel, and verteporfin. This review explores the molecular mechanisms, structural insights, and therapeutic implications of these compounds, highlighting their potential in targeted protein degradation, cancer treatment, and modulation of cellular processes, such as autophagy and immune response. The diverse effects of these molecules underscore the complexity of protein polymerization in cellular function and disease, opening new avenues for drug discovery and development."

Journal • Oncology • Targeted Protein Degradation • BCL6 • PML • RARA • STING

Concurrent Primary Sclerosing Cholangitis and Acute Promyelocytic Leukemia: A Rare Case Report (ACG 2025) - "Biopsy of the L5 lesion confirmed myeloid sarcoma, and the patient was started on arsenic trioxide and all-trans retinoic acid (ATO+ATRA). Imaging showed progression of PSC with increased peripheral biliary dilation and multifocal intrahepatic and extrahepatic biliary strictures, along with wall thickening and enhancement, raising concern for ATRA-related PSC progression. This case highlights a rare concurrence of PSC and APL, raising the question of a possible association between the two diseases. The observed PSC progression following APL diagnosis and treatment presents a clinical dilemma: whether the progression was drug-induced or simply reflects the natural course of PSC.Figure: MRI showing a new enhancing lesion at the T12 vertebra, concerning for myeloid sarcoma in a patient with acute promyelocytic leukemia."

Case report • Clinical • Acute Myelogenous Leukemia • Acute Promyelocytic Leukemia • Fatigue • Fibrosis • Hematological Malignancies • Hepatology • Immunology • Leukemia • Movement Disorders • Sarcoma • Solid Tumor

A Rare t(3;15;17) in a Patient with Acute Promyelocytic Leukemia: Case Report and Review of the Literature. (PubMed, Diagnostics (Basel)) - "Treatment at the hospital with standard APL therapy of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) was complicated by the development of differentiation syndrome, which necessitated the temporary stoppage of ATO. However, complete remission was achieved despite complications after starting consolidation treatment."

Journal • Acute Promyelocytic Leukemia • Endometrial Cancer • Hematological Disorders • Hematological Malignancies • Leukemia • Oncology • Solid Tumor

Gilteritinib-Based Salvage and Donor Lymphocyte Infusions in Multiply Relapsed APL With FLT3-ITD: A Case-Based Strategy for Post-Transplant Relapse (SOHO 2025) - "Treatment with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) achieves long-term remission in most cases...Her initial relapse occurred in March 2023, and she underwent salvage with ATRA/ATO and idarubicin, followed by autologous HCT in August 2023 in CMR2. A second relapse in January 2024 (day +154, T-cell chimerism 52% donor, blasts 30% by differential) was treated with ATRA/ATO and gemtuzumab ozogamicin (GO)...In January 2025, she began DLI with concurrent low-dose ATRA, 6-mercaptopurine, and methotrexate... This case demonstrates an unconventional approach to relapsed FLT3-ITD APL using DLI and gilteritinib. Although neither therapy is typically employed in APL, their combination resulted in CMR with excellent tolerability and no GVHD. These findings suggest that integrating a FLT3 inhibitor with immunotherapeutic augmentation may offer a viable salvage pathway for patients with relapsed, high-risk APL."

Clinical • IO biomarker • Post-transplantation • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology • FLT3 • PML

Safety and efficacy of arsenic trioxide in intensification therapy for newly diagnosed childhood acute promyelocytic leukemia: results from the JPLSG AML-P13 study. (PubMed, Int J Hematol) - "Furthermore, no cardiac, metabolic, renal, cutaneous, or neurological symptoms were reported for up to 5 years after completion of the protocol therapy. The JPLSG AML-P13 study demonstrated excellent outcomes and safety of ATO in children with APL."

Journal • Acute Myelogenous Leukemia • Acute Promyelocytic Leukemia • CNS Disorders • Hematological Disorders • Hematological Malignancies • Leukemia • Leukopenia • Neutropenia • Oncology • Pediatrics

Treatment Outcomes of All-Trans Retinoic Acid, Arsenic Trioxide, and Daunorubicin in High-Risk Pediatric Acute Promyelocytic Leukemia: A Single-Center Study From a Quaternary Care Center in South India (SOHO 2025) - "This study demonstrates that the use of ATRA, ATO, and DNR for induction, followed by ATRA and ATO for consolidation, is a feasible and effective treatment strategy in pediatric high-risk APL. Despite early mortality prior to treatment initiation, those who completed therapy had excellent long-term outcomes with no relapses. Our findings suggest that therapeutic protocols established for adults can be safely adapted for pediatric use, offering promising results in a disease historically associated with poor prognosis in high-risk groups."

Clinical • Acute Promyelocytic Leukemia • Hematological Malignancies • Leukemia • Oncology

Assessing the Impact of All-Trans Retinoic Acid (ATRA)- and Arsenic Trioxide (ATO)-Based Therapy in Pediatric Acute Promyelocytic Leukemia: A Single-Center Study. (PubMed, Cureus) - "This study reinforces the effectiveness of ATRA-ATO-based regimens in managing paediatric APL. However, induction-related complications such as febrile neutropenia, transaminitis, and QTc prolongation highlight the need for vigilant monitoring and robust supportive care. Timely diagnosis and early initiation of therapy remain key to improving outcomes."

Journal • Acute Myelogenous Leukemia • Acute Promyelocytic Leukemia • Febrile Neutropenia • Hematological Disorders • Hematological Malignancies • Leukemia • Neutropenia • Oncology • Pediatrics • PML

Clinical characteristics and outcome of pediatric patients with high-risk acute promyelocytic leukemia, with special focus on risk factors of early death. (PubMed, Ann Hematol) - "To evaluate the real-life outcome of pediatric high-risk acute promyelocytic leukemia (APL) after up-front treatment with all-trans retinoic acid (ATRA) and arsenic trioxide...ED remains the primary threat in high-risk APL, associated with elevated WBCs, prolonged PT, female gender and rapid disease progression. The inability of ATRA to prevent death in some cases may be due to individual variability and leukemia heterogeneity."

Journal • Acute Myelogenous Leukemia • Acute Promyelocytic Leukemia • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Hematological Malignancies • Leukemia • Oncology • Pediatrics