{"entity":{"id":"asparaginase","kind":"drug","name":"Asparaginase (pegaspargase, calaspargase pegol, Erwinia asparaginase)","aka":[],"tldr":"An enzyme that starves leukaemia cells of an amino acid they cannot make; a mainstay of childhood ALL therapy for 50 years, with new versions solving allergy and supply problems.","summary":"E. coli asparaginase (1978), pegaspargase (1994; first-line 2006), calaspargase pegol (2018, longer interval) and recombinant Erwinia asparaginase (Rylaze, 2021) after Erwinaze shortages. Asparaginase intensity underlies paediatric-inspired adult ALL regimens. Toxicities: hypersensitivity, pancreatitis, thrombosis, hepatotoxicity, hyperglycaemia; silent inactivation is monitored by asparaginase activity levels.","status":"approved","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Asparaginase","links":[{"label":"Label: Rylaze (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Rylaze"}],"tags":["gap-fill"],"related":[],"cancers":["all-leukemia","peripheral-t-cell-lymphoma"],"sections":[],"technologies":["cytotoxic-chemotherapy"],"targets":[],"drugs":[],"companies":["servier","jazz"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Oncaspar / Asparlas / Rylaze / Erwinaze","modality":"Enzyme therapy","mechanism":"Depletes plasma asparagine (and glutamine), starving lymphoblasts that lack asparagine synthetase; pegylation extends half-life, Erwinia-derived enzyme avoids cross-reactive hypersensitivity.","approvals":[{"region":"US","year":1994,"indication":"ALL (pegaspargase, hypersensitivity to native); first line 2006"},{"region":"US","year":2018,"indication":"ALL in patients 1 month-21 years (calaspargase pegol)"},{"region":"US","year":2021,"indication":"ALL/LBL with hypersensitivity to E. coli asparaginase (Rylaze)"},{"region":"EU","year":2016,"indication":"Oncaspar centralised 2016; Erwinase and native asparaginases national"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/asparaginase/","neighbours":{"cancer":[{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/"},{"id":"aya-cancers","kind":"cancer","name":"Adolescent and young adult cancers (ages 15 to 39)","route":"/cancers/aya-cancers/"},{"id":"extranodal-nk-t-cell-lymphoma","kind":"cancer","name":"Extranodal NK/T-cell lymphoma","route":"/cancers/extranodal-nk-t-cell-lymphoma/"},{"id":"all-paediatric-high-risk","kind":"cancer","name":"High-risk acute lymphoblastic leukaemia in children (high-risk B-ALL and T-ALL)","route":"/cancers/all-paediatric-high-risk/"},{"id":"all-infant","kind":"cancer","name":"Infant acute lymphoblastic leukaemia (KMT2A-rearranged, under one year)","route":"/cancers/all-infant/"},{"id":"peripheral-t-cell-lymphoma","kind":"cancer","name":"Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)","route":"/cancers/peripheral-t-cell-lymphoma/"},{"id":"all-paediatric-ph-positive","kind":"cancer","name":"Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL)","route":"/cancers/all-paediatric-ph-positive/"},{"id":"all-paediatric-relapsed","kind":"cancer","name":"Relapsed and refractory acute lymphoblastic leukaemia in children","route":"/cancers/all-paediatric-relapsed/"},{"id":"all-paediatric-standard-risk","kind":"cancer","name":"Standard-risk B-cell acute lymphoblastic leukaemia in children","route":"/cancers/all-paediatric-standard-risk/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}],"company":[{"id":"jazz","kind":"company","name":"Jazz Pharmaceuticals","route":"/companies/jazz/"},{"id":"servier","kind":"company","name":"Servier","route":"/companies/servier/"}],"term":[{"id":"lymphoma-tx-regimen-alphabet","kind":"term","name":"The lymphoma regimen alphabet: R-CHOP, pola-R-CHP, DA-EPOCH-R, ABVD, BEACOPP and the rest","route":"/terms/lymphoma-tx-regimen-alphabet/"}],"trial":[{"id":"nct04293562","kind":"trial","name":"A Study to Compare Standard Chemotherapy to Therapy With CPX-351 and/or Gilteritinib for Patients With Newly Diagnosed AML With or Without FLT3 Mutations","route":"/trials/nct04293562/"},{"id":"aall0232","kind":"trial","name":"AALL0232","route":"/trials/aall0232/"},{"id":"aall1231","kind":"trial","name":"AALL1231","route":"/trials/aall1231/"},{"id":"ukallr3","kind":"trial","name":"ALL R3 (UKALLR3)","route":"/trials/ukallr3/"},{"id":"nct02883049","kind":"trial","name":"Combination Chemotherapy in Treating Young Patients With Newly Diagnosed High-Risk B Acute Lymphoblastic Leukemia and Ph-Like TKI Sensitive Mutations","route":"/trials/nct02883049/"},{"id":"nct00003436","kind":"trial","name":"Combination Chemotherapy With or Without Bone Marrow Transplantation in Treating Children With Acute Myeloid Leukemia","route":"/trials/nct00003436/"},{"id":"nct00557193","kind":"trial","name":"Combination Chemotherapy With or Without Lestaurtinib in Treating Younger Patients With Newly Diagnosed Acute Lymphoblastic Leukemia","route":"/trials/nct00557193/"},{"id":"nct02521493","kind":"trial","name":"Response-Based Chemotherapy in Treating Newly Diagnosed Acute Myeloid Leukemia or Myelodysplastic Syndrome in Younger Patients With Down Syndrome","route":"/trials/nct02521493/"},{"id":"smile-enktl","kind":"trial","name":"SMILE","route":"/trials/smile-enktl/"},{"id":"nct01700946","kind":"trial","name":"Therapy for Pediatric Relapsed or Refractory Precursor B-Cell Acute Lymphoblastic Leukemia and Lymphoma","route":"/trials/nct01700946/"}],"paper":[{"id":"paper-smile-chemotherapy-nk-t-cell-lymphoma-jco-2011","kind":"paper","name":"Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study","route":"/key-papers/paper-smile-chemotherapy-nk-t-cell-lymphoma-jco-2011/"}],"roadmap":[{"id":"lymphoma-roadmap","kind":"roadmap","name":"Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting","route":"/roadmaps/lymphoma-roadmap/"},{"id":"paediatric-oncology-roadmap","kind":"roadmap","name":"Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first","route":"/roadmaps/paediatric-oncology-roadmap/"}],"idea":[{"id":"lymphoma-ev-randomised-evidence-for-the-t-cell-lymphomas","kind":"idea","name":"Randomised evidence for the T-cell lymphomas, including the ones that are not in Europe or North America","route":"/ideas/lymphoma-ev-randomised-evidence-for-the-t-cell-lymphomas/"},{"id":"lymphoma-ev-the-drugs-that-cure-and-the-places-without-them","kind":"idea","name":"The drugs that cure lymphoma, and the places that do not have them","route":"/ideas/lymphoma-ev-the-drugs-that-cure-and-the-places-without-them/"}],"pathway":[{"id":"glutamine-metabolism","kind":"pathway","name":"Glutamine addiction","route":"/pathways/glutamine-metabolism/"}],"drug":[{"id":"crisantaspase","kind":"drug","name":"Crisantaspase (recombinant Erwinia asparaginase)","route":"/drugs/crisantaspase/"}]}}