Alison R. Sehgal, MD, discusses key targetable alterations in acute myeloid leukemia.
Alison R. Sehgal, MD, assistant professor of medicine, hematologist/medical oncologist, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, discusses key targetable alterations in acute myeloid leukemia (AML).
IDH1/2 mutations are important targetable alterations in AML. Moreover, the targeted therapies ivosidenib (Tibsovo), an IDH1 inhibitor and enasidenib (Idhifa), an IDH2 inhibitor are approved for use in patients with AML. Further evaluation of these therapies is planned to determine whether combination strategies could be more beneficial to patients, Sehgal says.
Additionally, gilteritinib (Xospata), a FLT3 inhibitor, received regulatory approval in November 2018 for the treatment of adult patients with relapsed/refractory AML, who harbor FLT3 mutations, as detected by an FDA-approved test. Like ivosidenib and enasidenib, gilteritinib is undergoing further testing to determine if it is more effective when used in combination regimens. Additionally, data are emerging regarding the role of gilteritinib in the pre- and post-transplant settings for patients with AML, Sehgal adds.
Notably, the lack of agents that target TP53 represents an unmet need in the AML space; however, ongoing research efforts are evaluating different therapies that may yield a survival advantage in patients who harbor TP53 mutations, Sehgal concludes.