ASH 2024 | Real-world effectiveness of midostaurin versus quizartinib in FLT3-ITD mutated AML

Another big question in really all of heme malignancy, but in particular where we have targeted therapies, is what are the strengths and weaknesses, what are the benefits of different targeted therapies? In particular, we were interested in how new targeted treatments such as quizartinib, a newly approved FLT3 inhibitor, what distinguishes that? Are there strengths or weaknesses compared to our old standby of midostaurin. As you know, midostaurin was approved in combination with 7+3 and then in consolidation and maintenance setting. And more recently, quizartinib was also approved, but the two have not really been compared head to head. And so we worked with a number of other institutions to collect data on the response rates, some preliminary data on MRD achievement, and then also some ongoing data collection on relapse and survival. And what we found is so far that there’s fairly similar response rates. Now we are trying to look into the depth of those responses. And in particular, although our follow-up is short, we’re curious about risk of relapse. You know, if we use a more potent FLT3 inhibitor, does that somehow modify the risk of relapse? And so we do need some ongoing follow-up. We’re also kind of working with some other sites to expand these numbers. But I think this will really create an important question of which patients benefit most from our existing strategy of midostaurin, and are there a number of patients who really, there’s a different benefit from using quizartinib instead. And so as we get more targeted therapies, I think these kind of comparative effectiveness type of studies will be increasingly important, or at least provide fodder for maybe further prospective trials.

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