Gilteritinib with or without venetoclax for relapsed/refractory FLT3-mutated acute myeloid leukaemia.

Autor: Kugler E; Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.; The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Cohen I; Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel., Amitai I; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.; Haematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel., Ram R; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.; Institute of Haematology, Tel-Aviv Sourasky Medical Center (TLVMC), Tel-Aviv, Israel., Frisch A; Department of Haematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.; Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel., Nachmias B; Department of Haematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Canaani J; Weill Medical College of Cornell University, New York, New York, USA., Moshe Y; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.; Institute of Haematology, Tel-Aviv Sourasky Medical Center (TLVMC), Tel-Aviv, Israel., Krayem B; Department of Haematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.; Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel., Aumann S; Department of Haematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Henig I; Department of Haematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.; Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel., Vainstein V; Department of Haematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Shargian L; Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel., Ganzel C; Department of Haematology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel., Yeshurun M; Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel., Levi I; Haematology Institute, Soroka Medical Center, Beer-Sheba, Israel., Raanani P; Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel., Akria L; Department of Haematology, Galilee Medical Center, Naharyia, Azrieli Faculty of Medicine Bar Ilan University, Sefad, Israel., Ofran Y; Department of Haematology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel., Shimony S; Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA., Wolach O; Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 Sep; Vol. 205 (3), pp. 932-941. Date of Electronic Publication: 2024 May 23.
DOI: 10.1111/bjh.19548
Abstrakt: Patients with FLT3-mutated acute myeloid leukaemia (AML) that relapse or are refractory (R/R) to intensive induction have poor outcomes. Gilteritinib has recently become standard-of-care for patients with R/R FLT3-mutated AML. We investigated whether adding venetoclax to gilteritinib (gilt-ven) improves outcomes as compared with gilteritinib monotherapy. We included patients treated with gilteritinib (n = 19) and gilt-ven (n = 17) for R/R AML after intensive chemotherapy. Gilteritinib and gilt-ven groups did not differ in terms of mCRc rates (53% and 65%, p = 0.51) and realization of allogeneic haematopoietic stem-cell transplantation (HSCT, 47% and 35%, p = 0.5). Overall survival (OS) was comparable between groups, although a trend towards better OS was seen with gilt-ven (12-month OS 58.8% [95% CI 39.5%-87.6%]) versus gilteritinib (42.1% [95% CI 24.9%-71.3%] for gilteritinib). Early salvage with gilt-ven versus any other gilteritinib-based approach was associated with the best outcome (p = 0.031). Combination therapy was associated with increased haematological toxicity. In summary, gilt-ven did not improve remissions or HSCT-realization rates in patients with R/R FLT3-mutated AML as compared with gilteritinib and was associated with increased haematological toxicity. Although OS did not differ, a trend towards better survival was suggested with gilt-ven and a survival benefit was shown for gilt-ven approach when sequenced early for salvage.
(© 2024 British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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