The Current Therapeutic Landscape of FLT3 Inhibitors

In this 15-minute audio presentation, Dr. Mark Levis of Johns Hopkins University reviews the current clinical status of the FLT3 inhibitors midostaurin, quizartinib, gilteritinib, sorafenib, and crenolanib in treating patients with FLT3-mutated acute myeloid leukemia (AML).

Dr. Levis notes that finding the right therapeutic use for each of these drugs involves making several clinical decisions, most importantly determining whether to use a more potent, selective inhibitor or a more multi-targeted one.

Dr. Levis notes that the RATIFY trial demonstrated that the addition of midostaurin to induction and consolidation chemotherapy improves the overall survival of patients with newly diagnosed FLT3-mutated AML, and as such, midostaurin should be a part of the standard-of-care for these patients.

“It is now incumbent on every practitioner to determine a patient’s FLT3 mutation status within a week of the initial diagnosis,” he states. To rapidly determine FLT3 status, Dr. Levis recommends using an assay that provides practitioners with results in time to start midostaurin by day 8 in FLT3+ patients.

Other factors Dr. Levis discusses include the pros and cons of administering these agents with induction and consolidation, in the pre- or post-transplant setting, or as maintenance therapy. In the relapsed setting, he discusses their utility as monotherapy or in combination with chemotherapy.

In conclusion, Dr. Levis stated “I don’t think that the use of midostaurin should change the emphasis on allogeneic transplant. In the RATIFY trial, the group of patients with the best overall survival were those that had received midostaurin and then underwent a transplant in first remission.”

Explore additional research advancements affecting AML treatment planning in a 10-minute podcast featuring Dr. Linda J. Burns, VP and Medical Director of Health Services Research at NMDP/Be The Match.

Levis M. Blood Advances

Editor’s note: Transcripts of Blood Advances podcasts undergo the same peer-review process as all articles published in the journal.

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