Clinical outcomes in patients with relapsed/refractory FLT3-mutated acute myeloid leukemia treated with gilteritinib who received prior midostaurin or sorafenib

被引：0

作者：

Alexander E. Perl

Naoko Hosono

Pau Montesinos

Nikolai Podoltsev

Giovanni Martinelli

Nicki Panoskaltsis

Christian Recher

Catherine C. Smith

Mark J. Levis

Stephen Strickland

Christoph Röllig

Marco Groß-Langenhoff

Wen-Chien Chou

Je-Hwan Lee

Hisayuki Yokoyama

Nahla Hasabou

Qiaoyang Lu

Ramon V. Tiu

Jessica K. Altman

机构：

[1] Abramson Cancer Center,

[2] University of Pennsylvania,undefined

[3] University of Fukui,undefined

[4] Hospital Universitario y Politécnico La Fe,undefined

[5] Yale School of Medicine,undefined

[6] Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori” IRST S. r. l,undefined

[7] Winship Cancer Institute,undefined

[8] Emory University School of Medicine,undefined

[9] Cancer Research Center of Toulouse,undefined

[10] University of California-San Francisco,undefined

[11] The Sidney Kimmel Comprehensive Cancer Center,undefined

[12] Johns Hopkins University,undefined

[13] Vanderbilt Ingram Cancer Center,undefined

[14] Universitätsklinikum Carl Gustav Carus,undefined

[15] Astellas Pharma GmbH,undefined

[16] National Taiwan University Hospital,undefined

[17] Asan Medical Center,undefined

[18] University of Ulsan College of Medicine,undefined

[19] Sendai Medical Center,undefined

[20] National Hospital Organization,undefined

[21] Astellas Pharma US,undefined

[22] Robert H. Lurie Comprehensive Cancer Center,undefined

[23] Northwestern University Feinberg School of Medicine,undefined

[24] Tohoku University,undefined

[25] National Hospital Organization,undefined

来源：

Blood Cancer Journal | / 12卷

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摘要：

The fms-like tyrosine kinase 3 (FLT3) inhibitor gilteritinib is indicated for relapsed or refractory (R/R) FLT3-mutated acute myeloid leukemia (AML), based on its observed superior response and survival outcomes compared with salvage chemotherapy (SC). Frontline use of FLT3 tyrosine kinase inhibitors (TKIs) midostaurin and sorafenib may contribute to cross-resistance to single-agent gilteritinib in the R/R AML setting but has not been well characterized. To clarify the potential clinical impact of prior TKI use, we retrospectively compared clinical outcomes in patients with R/R FLT3-mutated AML in the CHRYSALIS and ADMIRAL trials who received prior midostaurin or sorafenib against those without prior FLT3 TKI exposure. Similarly high rates of composite complete remission (CRc) were observed in patients who received a FLT3 TKI before gilteritinib (CHRYSALIS, 42%; ADMIRAL, 52%) and those without prior FLT3 TKI therapy (CHRYSALIS, 43%; ADMIRAL, 55%). Among patients who received a prior FLT3 TKI in ADMIRAL, a higher CRc rate (52%) and trend toward longer median overall survival was observed in the gilteritinib arm versus the SC arm (CRc = 20%; overall survival, 5.1 months; HR = 0.602; 95% CI: 0.299, 1.210). Remission duration was shorter with prior FLT3 TKI exposure. These findings support gilteritinib for FLT3-mutated R/R AML after prior sorafenib or midostaurin.

引用

共 194 条

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