Dr. Patel on the Role of Gilteritinib in FLT3+ AML

Prapti Patel, MD, assistant professor, Department of Internal Medicine, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, discusses the role of gilteritinib (Xospata) in patients with FLT3-mutated acute myeloid leukemia.

Preliminary data for gilteritinib presented at the 2019 AACR Annual Meeting looked at patients with FLT3-ITD or FLT3-TKD mutations, who were randomized 2:1 to receive gilteritinib alone versus chemotherapy, explains Patel. Patients were permitted to go onto transplant and, if randomized to the gilteritinib arm, were also allowed to receive maintenance gilteritinib therapy afterward. The response rates in patients receiving gilteritinib doubled compared with patients receiving chemotherapy alone, indicating gilteritinib, an oral targeted therapy, as the superior option for this patient population, according to Patel.

Gilteritinib is less toxic than chemotherapy because it is targeted, says Patel. Patients who underwent transplant were treated with a targeted therapy that was not as toxic, and were therefore more fit to undergo transplant. As a result, they were able to tolerate the transplant better and have an option for maintenance therapy to prevent relapse after transplant, which is a concern for patients with aggressive FLT3 mutations, concludes Patel.