Using Triplet FLT3 Inhibitor–Based Therapy for Older Patients With AML
Posted: Wednesday, January 12, 2022
According to findings presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 798), using hypomethylating agent therapy plus venetoclax and FLT3 inhibitor–based triplet regimen to treat patients with newly diagnosed FLT3-mutated acute myeloid leukemia (AML) may improve outcomes, particularly for older and unfit patients. Naval Daver, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues found that the triplet regimen produced these results without increasing early mortality.
“These findings suggest the need for prospective validation of [hypomethylating agent/venetoclax/FLT3 inhibitor] triplets in older/unfit [patients with] AML,” the authors concluded.
In this retrospective analysis, the authors identified 87 patients with newly diagnosed FLT3-mutated AML who qualified as “older” and “unfit.” The patients analyzed had been previously treated in FLT3 inhibitor–based clinical trials.
Of the patients, 60 were treated with low-intensity chemotherapy with FLT3 inhibitors (69%), and 27 received low-intensity chemotherapy plus venetoclax and FLT3 inhibitors (31%). Of the former group, 44 were treated with a first-generation FLT3 inhibitor (either sorafenib or midostaurin), and 16 received the second-generation inhibitor quizartinib. There was no statistically significant difference in complete response rate, complete response with incomplete hematologic recovery rate, multicolor flow cytometry negativity rates, and multiplex polymerase chain reaction negativity rates when comparing the first- and second-generation inhibitors, as well as for overall survival.
Patients treated with triplet regimens had higher complete response and complete response with incomplete hematologic recovery rates than those treated with doublet regimens (93% vs. 70%, respectively), as well as higher multiplex polymerase chain reaction negativity rates (96% vs. 54%, respectively) and multicolor flow cytometry negativity rates (83% vs. 38%, respectively). The 60-day mortality rate was similar between the two cohorts: two deaths in the triplet regimen compared with six in the doublet regimen.
Disclosure: For full disclosures of the study authors, visit ash.com.