EHA 2025 | The current standard approach to frontline treatment for patients with FLT3-mutated AML

The current standard approach in younger patients with FLT3-mutated AML is in the United States, intensive chemotherapy plus a FLT3 inhibitor. The most common form of intensive chemotherapy is 7 plus 3 and there are two drugs that are approved, midostaurin and quizartinib, that are initiated on day 8 of 7 plus 3. So they’re combined with 7 plus 3 or other intensive regimens in FLT3 mutated younger patients who are eligible for intensive therapy. For older patients or those who are not eligible for intensive therapies like 7 and 3, there is really not a standard approach that incorporates FLT3 inhibitors. You can use HMA and venetoclax, but the data is kind of mixed, particularly when it comes to FLT3 ITD mutations. I’m conducting a large randomized study, not in FLT3-mutated patients, but in upfront younger patients to bring HMA venetoclax as a potential option in younger patients. It’s approved for older patients. I want to see if in younger patients it could be equally efficacious given that it’s milder and maybe less toxic, much less toxic than intensive therapies. And over time, perhaps, we can use HMA venetoclax as a scaffolding, as a sort of a baseline to then add novel therapies like FLT3 inhibitors, IDH inhibitors, menin inhibitors to sort of allow a more gentle approach for younger patients and older patients to potentially benefit from targeted agents in the upfront setting.

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