Intensive Chemotherapy in Combination with Quizartinib versus Midostaurin for FLT3-ITD Mutated Acute Myeloid Leukemia: A Multicenter Cohort Study

Amir T. Fathi, MD, presents findings from a multicenter retrospective cohort study evaluating intensive chemotherapy (IC) plus quizartinib vs IC plus midostaurin in 215 patients with newly diagnosed FLT3-ITD–mutated acute myeloid leukemia (AML) treated across 12 US cancer centers between 2017 and 2025. The IC-plus-quizartinib regimen was associated with a significantly higher 1-year overall survival rate (93% vs 78%), which persisted after adjustment for baseline covariates (HR, 0.19; 95% CI, 0.07-0.52). Patients receiving quizartinib also experienced a higher rate of composite complete remission (OR, 2.19; 95% CI, 1.01-4.76) and improved 1-year event-free survival (77% vs 56%; HR, 0.44; 95% CI, 0.25-0.77), with lower rates of relapse and death. Additionally, quizartinib-treated patients had fewer treatment interruptions, reduced ICU utilization, and lower rates of discharge to rehabilitation. Post-induction minimal residual disease negativity was comparable between groups. These real-world data support superior 1-year efficacy and safety outcomes with IC plus quizartinib over IC plus midostaurin.