Each subtype was classified by gene expression clustering, and showed specific patterns of genetic alterations, particularly for four genes: platelet - derived growth factor receptor alpha (PDGFRA),
isocitrate dehydrogenase 1 (IDH1), epidermal growfth factor receptor (EGFR), and neurofibromin 1 (NF1).
Enasidenib is the first
isocitrate dehydrogenase 2 (IDH2) inhibitor approved by the FDA, indicated for adults with relapsed or refractory AML and IDH2 mutations as detected by an approved assay.
That case became even stronger with the discovery in 2008 of a mutated gene for a metabolic enzyme called IDH (
isocitrate dehydrogenase) in some leukemias, brain cancers, and gall bladder and gastrointestinal cancers.
Two cases harbored mutations in
isocitrate dehydrogenase 2 (IDH2), a gene known to be recurrently mutated in AML, glioblastoma, and other tumors.
A pyruvate cycling pathway involving cytosolic NADP - dependent
isocitrate dehydrogenase regulates glucose - stimulated insulin secretion.
The key to controlling which route isocitrate will take seems to lie in the enzymes surrounding all these reactions: the enzyme
isocitrate dehydrogenase keeps it for the fat - metabolism and energy production cycle; the enzymes isocitrate lyase and malate synthase divert it away into biosynthetic processes in the bacterium.
Cells secrete 2HG when
the isocitrate dehydrogenase 1 (IDH1) or IDH2 genes are mutated.
It's particularly because components of the citric acid cycle, specifically
isocitrate dehydrogenases 1 and 2 (IDH1 and IDH2) have recently emerged as oncogenes that are recurrently mutated in gliomas and leukemias.