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EHA 2026 | Selecting FLT3 inhibitors in AML: evolving evidence and clinical considerations
Robert Negrin, MD, Stanford University, Stanford, CA, discusses the evolving role of FLT3 inhibitors in acute myeloid leukemia (AML), highlighting how increasing knowledge of FLT3-mutated disease has transformed frontline treatment decisions. Prof. Negrin reviews key considerations when selecting among available FLT3 inhibitors, including toxicity profiles, clinical experience, accessibility, and emerging data favoring more selective agents. He also shares insights into the use of gilteritinib in clinical practice and the need for further comparative studies to guide treatment selection. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
Yes, clearly the introduction of knowledge about different mutations in AML has made a major impact on how we take care of patients, with FLT3 mutations being critically important. We recognize that there are multiple different agents that can be used in treating these patients, and a lot of it comes down to personal choice and what available data we have. Unfortunately, there’s not much randomized data comparing these different agents...
Yes, clearly the introduction of knowledge about different mutations in AML has made a major impact on how we take care of patients, with FLT3 mutations being critically important. We recognize that there are multiple different agents that can be used in treating these patients, and a lot of it comes down to personal choice and what available data we have. Unfortunately, there’s not much randomized data comparing these different agents. So a lot of it has to do with toxicity concerns and what the available studies teach us. So we’re really excited about the session here at the meeting, which will update us on the use of different inhibitors. The more selective inhibitors seem to be those that are gaining more interest and gaining more traction just because they appear to have fewer toxicities. That’s often the major consideration. In addition to the benefit, what are the toxicities? Of course, what are the costs of these agents? And they can vary from institution to institution. And also, of course, what is available wherever you tend to practice. These are all different considerations that we use. In our practice, we tend to use more gilteritinib. It’s the agent that we’re most familiar with and for which we tend to use in our particular environment because it seems to be quite well tolerated and has excellent efficacy. But other agents are coming along and we’ll see how they fare.
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