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Turning arsenic into medicine

Arsenicals have been used therapeutically for more than 2,000 years, generally in the Far East, as part of traditional Chinese medicine. They became a therapeutic mainstay for various ailments in the 19th and early 20th centuries.1-3 Eventually, arsenic compounds were replaced by radiotherapy and cytotoxic chemotherapeutic agents. The decline in the medicinal use of arsenic in Western medicine can also be traced to concerns about toxicity.1,2

Arsenic trioxide was reintroduced as an anticancer agent after reports emerged from China of the success of an arsenic trioxide-containing herbal mixture for the treatment of acute promyelocytic leukemia (APL).1 Pioneering studies from China clearly demonstrated the marked activity of single-agent arsenic trioxide in APL and stimulated the development of arsenic trioxide in the United States, and clinical investigations led to its approval by the U.S. Food and Drug Administration in 2000 for the treatment of relapsed or refractory APL.1

TRISENOX® (arsenic trioxide) injection has been shown to be efficacious in inducing high rates of complete and molecular remission in APL patients who have relapsed after, or did not respond to, their initial therapy.

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TRISENOX is indicated for induction of remission and consolidation in patients with APL who are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression.
1. Douer D, Tallman MS. Arsenic trioxide: new clinical experience with an old medication in hematologic malignancies. J Clin Oncol. 2005;23:2396-2410.
2. Antman KH. Introduction: The history of arsenic trioxide in cancer therapy. Oncologist. 2001;6 Suppl 2:1-2.
3. Waxman S, Anderson KC. History of the development of arsenic derivatives in cancer therapy. Oncologist. 2001;6 Suppl 2:3-10.
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