SOHO 2025 | Incorporating FLT3 inhibitors into the management of patients with AML

The first thing is just first off to use them, to use them with every stage of treatment and that’s standard with intensive chemotherapy that we’ve had the opportunity to use FLT3 inhibitors since the approval of midostaurin back in 2017, but it’s not yet standard to do this in the therapy of older patients who are getting lower intensity therapy. And the big question there is just is that ready for prime time? Can we use this widespread in our patients in place of venetoclax and azacitidine to add in a third drug, add in a FLT3 inhibitor, as is currently done with intensive chemotherapy? We’re still answering that question. I would not say we’re ready to just widespread do that because this could add toxicity, but we are doing clinical trials that will help clarify, is this ready for prime time? Is this something that we really should do routinely? And the preliminary data is very exciting. The data with triplet therapy with venetoclax, azacitidine, gilteritinib was published in 2024 by Nick Short. Extremely high remission rates and in patients that had a median age of upper 70s and very high MRD negative rates from those patients, which suggests that these remissions may be quite durable. The short-term follow up on that looks very promising in terms of one and two year survivals. It looks a lot better than what we’ve seen historically. And so now that there are randomized clinical trials, such as the MyeloMATCH study that I’m working with Jessica Altman, we’ll hopefully be able to look at this really across the country in newly diagnosed patients, genotype them, assign them to appropriate study, and figure out the relative merits of triplet versus doublet therapy.

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