The FMS-like tyrosine kinase 3 (FLT3) gene is mutated in approximately 30% of patients with acute myeloid leukemia (AML) and is indicative of a poor prognosis. Allogeneic hematopoietic stem cell transplantation (alloHSCT) is commonly recommended to this patient population as a consolidation therapy after first complete remission. Nevertheless, the rate of relapse post-alloHSCT remains high and effective post-transplant maintenance therapies represent an unmet clinical need. The FLT3 tyrosine kinase inhibitors (TKIs), including sorafenib, midostaurin and gilteritinib, have demonstrated improved outcomes for patients undergoing alloHSCT. Multiple ongoing trials are currently investigating these agents as maintenance therapies.
In this deep dive, Andreas Burchert, MD, University of Marburg, Marburg, Germany, discusses updates on post-transplant maintenance therapies for patients with FLT3+ AML, focusing on data from clinical trials evaluating four tyrosine kinase inhibitors: sorafenib, midostaurin, gilteritinib and quizartinib, as presented at the 6th Congress on Controversies in Stem Cell Transplantation and Cellular Therapies (COSTEM).