Treatment Patterns and FLT3 Mutation Testing Among Patients with Acute Myeloid Leukemia in China: A Retrospective Observational Study.

Autor: Gong B; Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China., Cheng LJ; Medical Affairs, Astellas Pharma Singapore Pte. Ltd, Singapore., Young CH; Advanced Informatics & Analytics, Astellas Pharma US Inc., Northbrook, IL, USA., Krishnan P; Medical Affairs, Astellas Pharma Singapore Pte. Ltd, Singapore., Wang Y; Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China., Wei H; Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China., Zhou C; Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China., Wei S; Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China., Li Y; Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China., Fang Q; Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China., Zhong J; Analysis Group, Inc., Beijing, People's Republic of China., Wu EQ; Analysis Group, Inc., Boston, MA, USA., Mi Y; Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China., Wang J; Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China.
Jazyk: angličtina
Zdroj: Therapeutics and clinical risk management [Ther Clin Risk Manag] 2024 Feb 08; Vol. 20, pp. 59-73. Date of Electronic Publication: 2024 Feb 08 (Print Publication: 2024).
DOI: 10.2147/TCRM.S434556
Abstrakt: Introduction: For acute myeloid leukemia (AML), prognosis is particularly poor in patients harboring FMS-like tyrosine kinase 3 ( FLT3 ) gene mutations, though routine screening for these mutations at diagnosis has been shown to be insufficient. The understanding of the impact of FLT3 mutations on treatment decisions is limited.
Methods: In this retrospective, observational study, we investigated the key epidemiological characteristics, treatment patterns and responses among adult patients with newly diagnosed (ND) AML in China, who initiated treatment from January 1, 2015, to December 31, 2019, or progressed to relapsed/refractory (R/R) AML by December 31, 2020.
Results: Of the 853 ND AML patients included, 63.4% were screened for FLT3 status, and 20.1% tested positive ( FLT3 MUT ) at initial diagnosis. Of 289 patients who progressed to R/R AML during the study period, 24.9% were screened at the diagnosis of R/R AML, and 19.4% tested positive; 20.5% of screened patients changed FLT3 status at first diagnosis of R/R AML. Initial treatment regimens or treatment responses did not seem to differ in patients with ND AML by FLT3 mutation status. In patients with R/R AML, there was an apparent difference in second-line treatment choices by FLT3 mutation status; however, the number of FLT3 -mutated patients were limited to demonstrate any meaningful distinction. FLT3 -mutated R/R AML was associated with shorter relapse time.
Conclusion: Study findings showed that there was a lack of routine testing for FLT3 mutations at first diagnosis of R/R AML, and initial treatment decisions did not differ by FLT3 mutation status. Given the clinical burden of FLT3 MUT , likelihood of FLT3 status changes, and emerging FLT3 inhibitors, further routine FLT3 screening is needed to optimize treatment of R/R AML.
Competing Interests: Li-Jen Cheng and Prabhuram Krishnan are employees of Astellas Pharma Singapore Pte. Ltd. Christopher H. Young is an employee of Astellas Pharma US Inc. Jia Zhong and Eric Q. Wu are employees of Analysis Group, Inc., an HEOR CRO company contracted by Astellas to undertake analysis. Jianxiang Wang participated in an advisory board for AbbVie. The authors report no other conflicts of interest in this work.
(© 2024 Gong et al.)
Databáze: MEDLINE
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