Early initiation of low-dose gilteritinib maintenance improves posttransplant outcomes in patients with R/R FLT3mut AML

Post‐stem cell transplant maintenance in FLT3mut acute myeloid leukemia – A retrospective analysis: Outcomes are improved with midostaurin but not with gilteritinib

“…Terao et al. found that relapsed/refractory (R/R) FLT3 AML patients who received post‐HSCT maintenance gilteritinib had improved overall survival (OS) (1‐year OS, 100% vs. 45.5%, p = 0.0075) and cumulative incidence of relapse (CIR, 1‐year CIR 0% vs. 68.8%, p = 0.0028) [ 4 ]. However, the phase 3 MORPHO trial failed to reach the primary outcome of improved relapse‐free survival (RFS) with post‐HSCT maintenance gilteritinib compared to placebo in FLT3‐ITD AML patients except in measurable residual disease (MRD) positive patients [ 5 ].…”

Innovations in conditioning and post-transplant maintenance in AML: genomically informed revelations on the graft-versus-leukemia effect

“…Gilteritinib is a selective FLT3 inhibitor which targets both ITD and tyrosine kinase domain (TKD) mutations, as well as exhibiting multikinase inhibitor activity against c-Kit and AXL, which has been implicated in resistance mechanisms to FLT3 inhibitors ( 101 , 102 ). Approval in the relapse/refractory setting was based on the ADMIRAL trial, and a retrospective study evaluated gilteritinib in this patient population post-alloHSCT ( 103 , 104 ). A follow-up to the ADMIRAL trial reported that 18 of 26 long-term survivors without relapse in the gilteritinib arm proceeded to alloHSCT, with 16 of 18 re-starting gilteritinib in the post-alloHSCT setting ( 105 ).…”