615. Acute Myeloid Leukemias: Commercially Available Therapies, Excluding Transplantation and Cellular Immunotherapies: Current approach to FLT3 mutated AML
Naval Daver, Alexander E. Perl, Joseph Maly, et al.
Regardless of prior TKI administration, R / R FLT3 + AML patients achieved a high mCRc and an encouraging mOS. A majority of patients had FLT3 mutation clearance. This resulted in a longer OS. The remission rates were particularly high in patients with NPM1 + +/- DNMT3A co-mutation. In general, encouraging rates of remission have been observed in many genotypes. By changing the dosage of Ven- or Gilt, the frequently occurring cytopenias could be controlled well. The authors will present further data (serial molecular NGS data / updated survival data) in the session.
Hartmut Döhner, Daniela Weber, Julia Krzykalla, et al.
The addition of midostaurin to intensive therapy results in both younger and older adult patients with AML and FLT3-ITD in a significant improvement in event-free survival and overall survival compared to a historical control cohort.
Maher Hanoun, Leo Ruhnke, Michael Kramer, et al.
Independent of the ELN risk group, this retrospective analysis did not find a significant advantage of high-dose cytarabine compared to the intermediate dosage in the consolidation for AML patients under 65 years of age.
Abhishek Maiti, Courtney D. DiNardo, Caitlin R. Rausch, et al.
DEC10-VEN resulted in high CR / CRi rates. Negative MRD, favorable OS, and RFS were also observed in several genomic subsets of treatment-naive AML. This also applies to NPM1, FLT3, IDH1/2. There were modest results in patients with these mutations in the salvage setting. Patients with TP53, RUNX1, ASXL1, and K/NRAS had suboptimal results. In contrast, the results with the FLT3 VEN HMA triplet were encouraging, especially for frontline therapy in patients with FLT3mut.
Jianxiang Wang, Bin Jiang, Jian Li, et al.
The results of the COMMODORE study in patients in Asia validate and confirm the clinical efficacy and safety data from the ADMIRAL study. The benefit of gilteritinib in R / R FLT3mut + AML is significant: it prolonged overall survival and event-free survival compared to salvage chemotherapy (SC) in patients with R / R FLT3mut + AML. The safety and tolerability of gilteritinib compared to SC was favorable.
Nicholas J. Short, Courtney D. DiNardo, Naval Daver, et al.
Patients with FLT3-mutated AML can benefit from an effective combination of azacitidine, venetoclax, and gilteritinib. Gilteritinib 80 mg daily resulted in a better safety/efficacy profile. This dose will be used for future studies. But be careful: even at this lower dose, myelosuppression is common. This requires a dose reduction of azacitidine and venetoclax. Frontline azacitidine, venetoclax, and gilteritinib result in a 100 percent response rate. No relapses have been observed so far.