{"entity":{"id":"arsenic-trioxide","kind":"drug","name":"Arsenic trioxide","aka":[],"tldr":"An ancient poison turned cure: with retinoic acid it cures more than 95% of acute promyelocytic leukaemia without conventional chemotherapy.","summary":"Developed from traditional Chinese medicine in Harbin (1990s); approved 2000 for relapsed APL and 2018 first line with tretinoin after APL0406 (Lo-Coco, NEJM 2013) showed ATRA-ATO superior to ATRA-chemotherapy in standard-risk APL. Toxicities: differentiation syndrome, QT prolongation, hepatotoxicity. Oral arsenic (Realgar-Indigo naturalis) is used in China.","status":"approved","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Arsenic_trioxide","links":[{"label":"APL0406 (NEJM 2013)","url":"https://doi.org/10.1056/NEJMoa1300874"},{"label":"Label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=arsenic%20trioxide"}],"tags":["gap-fill"],"related":["traditional-chinese-herbal-medicine"],"cancers":["aml","apl"],"sections":[],"technologies":["epigenetic-drugs"],"targets":[],"drugs":[],"companies":["teva"],"institutions":[],"pathways":[],"terms":["differentiation-syndrome"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Trisenox","modality":"Inorganic arsenical (differentiation agent)","mechanism":"Binds PML moiety of PML-RARA, inducing SUMOylation and degradation of the fusion oncoprotein; triggers differentiation and apoptosis of APL blasts.","approvals":[{"region":"US","year":2000,"indication":"Relapsed/refractory APL"},{"region":"US","year":2018,"indication":"Newly diagnosed low-risk APL with tretinoin"},{"region":"EU","year":2002,"indication":"APL"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/arsenic-trioxide/","neighbours":{"technology":[{"id":"epigenetic-drugs","kind":"technology","name":"Epigenetic drugs (HDAC, DNMT, EZH2, IDH, menin, BET)","route":"/technologies/epigenetic-drugs/"},{"id":"traditional-chinese-herbal-medicine","kind":"technology","name":"Traditional Chinese herbal medicine alongside treatment","route":"/technologies/traditional-chinese-herbal-medicine/"}],"cancer":[{"id":"aml","kind":"cancer","name":"Acute myeloid leukaemia","route":"/cancers/aml/"},{"id":"apl","kind":"cancer","name":"Acute promyelocytic leukaemia","route":"/cancers/apl/"}],"company":[{"id":"teva","kind":"company","name":"Teva Pharmaceuticals","route":"/companies/teva/"}],"term":[{"id":"cancer-stem-cell-theory","kind":"term","name":"Cancer stem cell theory and phenotypic plasticity","route":"/terms/cancer-stem-cell-theory/"},{"id":"differentiation-syndrome","kind":"term","name":"Differentiation syndrome","route":"/terms/differentiation-syndrome/"},{"id":"qt-prolongation","kind":"term","name":"QT prolongation","route":"/terms/qt-prolongation/"}],"target":[{"id":"pml","kind":"target","name":"PML","route":"/targets/pml/"},{"id":"rara","kind":"target","name":"Retinoic acid receptor alpha (RARA)","route":"/targets/rara/"},{"id":"txnrd1","kind":"target","name":"Thioredoxin reductase 1","route":"/targets/txnrd1/"}],"person":[{"id":"chen-saijuan","kind":"person","name":"Saijuan Chen","route":"/people/chen-saijuan/"},{"id":"chen-zhu","kind":"person","name":"Zhu Chen","route":"/people/chen-zhu/"}],"paper":[{"id":"paper-apl0406-lo-coco-nejm-2013","kind":"paper","name":"APL0406: retinoic acid plus arsenic trioxide without chemotherapy for low- and intermediate-risk acute promyelocytic leukaemia","route":"/key-papers/paper-apl0406-lo-coco-nejm-2013/"}],"institution":[{"id":"ruijin-hospital","kind":"institution","name":"Ruijin Hospital, Shanghai Jiao Tong University","route":"/institutions/ruijin-hospital/"}],"pathway":[{"id":"aml-signalling","kind":"pathway","name":"Acute myeloid leukaemia (KEGG map)","route":"/pathways/aml-signalling/"}],"trial":[{"id":"apl0406","kind":"trial","name":"APL0406","route":"/trials/apl0406/"}]}}