omacetaxine mepesuccinate; homoharringtonine (Synribo)

Indications

• treatment of chronic myelogenous leukemia (CML) resistant to 2 or more tyrosine kinase inhibitors

Adverse effects

• thrombocytopenia, anemia, neutropenia, lymphopenia
• diarrhea, nausea
• fatigue, asthenia
• injection site reaction
• pyrexia, infection

Mechanism of action

• inhibits protein translation by preventing the initial elongation step of protein synthesis
• interacts with the ribosomal A-site & prevents correct positioning of amino acid side chains of incoming aminoacyl-tRNAs
• acts only on the initial step of protein translation
• does not inhibit protein synthesis from mRNAs that have already begun translation

More general terms

• antineoplastic agent (chemotherapeutic agent)
• alkaloid