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. 2024 Mar;204(3):861-870.
doi: 10.1111/bjh.19182. Epub 2023 Nov 8.

Gilteritinib-based combination therapy in adult relapsed/refractory FLT3-mutated acute myeloid leukaemia

Nianci Chen  1   2   3 , Jiajia Pan  1   2   3 , Yile Zhou  1   2   3 , Liping Mao  1   2   3 , Yinjun Lou  1   2   3 , Jiejing Qian  1   2   3 , Gaixiang Xu  1   2   3 , Juying Wei  1   2   3 , De Zhou  1   2   3 , Lihong Shou  4 , Li Huang  5 , Minchao Yan  6 , Hui Zeng  6 , Cuihua Fan  7 , Gongqiang Wu  8 , Weiying Feng  9 , Hongyan Tong  1   2   3 , Jie Jin  1   2   3   10 , Huafeng Wang  1   2   3   10
Affiliations

Gilteritinib-based combination therapy in adult relapsed/refractory FLT3-mutated acute myeloid leukaemia

Nianci Chen et al. Br J Haematol. 2024 Mar.

Abstract

Gilteritinib, a potent FMS-like tyrosine kinase 3 (FLT3) inhibitor, was approved for relapsed/refractory (R/R) FLT3-mutated acute myeloid leukaemia (AML) patients but still showed limited efficacy. Here, we retrospectively analysed the efficacy and safety of different gilteritinib-based combination therapies (gilteritinib plus hypomethylating agent and venetoclax, G + HMA + VEN; gilteritinib plus HMA, G + HMA; gilteritinib plus venetoclax, G + VEN) in 33 R/R FLT3-mutated AML patients. The composite complete response (CRc) and modified CRc (mCRc) rates were 66.7% (12/18) and 88.9% (16/18) in patients received G + HMA + VEN, which was higher compared with that in G + HMA (CRc: 18.2%, 2/11; mCRc: 45.5%, 5/11) or G + VEN (CRc: 50.0%, 2/4; mCRc: 50.0%, 2/4). The median overall survival (OS) for G + HMA + VEN, G + HMA and G + VEN treatment was not reached, 160.0 days and 231.0 days. The median duration of remission (DOR) for G + HMA + VEN, G + HMA and G + VEN treatment was not reached, 82.0 days and 77.0 days. Four patients in the G + HMA + VEN group received alloHSCT after remission exhibited prolonged median DOR. The most common grade 3/4 adverse events were cytopenia, febrile neutropenia and pulmonary infection; there were no differences among the three groups. In conclusion, our data demonstrated promising response of G + HMA + VEN combination therapy in R/R FLT3-mutated AML, and it may be considered an effective therapy bridge to transplantation.

Keywords: FMS-like tyrosine kinase 3 mutation; acute myeloid leukaemia; gilteritinib; relapsed/refractory.

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Conflict of interest statement

The authors have no competing interests to declare.

References

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