ASH 2021 | Azacitidine, venetoclax and gilteritinib in previously untreated and R/R FLT3-mutated AML

Previous studies have found that patients with FLT3-mutated acute myeloid leukemia (AML) have worse outcomes than other patients with AML treated with hypomethylating agents (HMA) plus venetoclax. In addition, it has also been shown that the combination of azacitidine plus sorafenib, and azacitidine plus venetoclax in elderly and unfit patients with FLT3-mutated AML leads to high initial response rates (RR) but does not significantly prolong survival and relapses are common. In this video, Farhad Ravandi, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, gives an overview of the findings of a Phase I/II trial evaluating a triplet combination of azacitidine, venetoclax and gilteritinib in patients with FLT3-mutated AML (NCT04140487). The study first tested this combination in relapsed/refractory (R/R) patients where it reported high RRs but a modest duration of response (DOR), and subsequently in the frontline setting, where patients experienced RRs of 100% and a longer DOR. This promising combination could represent a new standard of care for the frontline treatment of older unfit FLT3-mutated patients with AML. In addition, this triplet regimen could be evaluated in young and fit patients prior to allogeneic stem cell transplant (alloSCT). This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.