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FLT3 Inhibitors Continue to Move Through AML Pipeline

Gina Columbus @ginacolumbusonc
Published: Friday, Jan 26, 2018

Catherine Smith, MD

Catherine Smith, MD
Though the 2017 FDA approval of midostaurin (Rydapt) in combination with standard cytarabine and daunorubicin induction and cytarabine consolidation for the treatment of adult patients with newly diagnosed FLT3-positive acute myeloid leukemia (AML) was an exciting milestone for the field, more selective FLT3 inhibitors are emerging in the pipeline that may improve outcomes even further.

on Hematologic Malignancies.

OncLive: What is important to highlight about FLT3-mutant AML?

Smith: FLT3 mutations are actually the most commonly found genetic alterations in AML. They come in 2 “flavors”: activating ITD mutations, and there is another subset of mutations that are point mutations found in the activation loop residue D835. We have known for a long time that FLT3-ITD mutations are a poor prognostic indication in AML. These result in increased relapse rates, decreased relapse-free survival rates, and decreased OS. For a long time, the field has looked for ways to mitigate the poor prognosis of these mutations. As a field, we have moved toward almost uniformly transplanting these patients and this does result in better outcomes for patients who are transplant candidates. 
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