QuANTUM-First: Updated results on quizartinib in AML with FLT3-ITD

Treatment with quizartinib resulted in an improved overall survival (OS) in patients with acute myeloid leukaemia (AML) with internal tandem duplications of the FLT3 gene (FLT3-ITD), regardless of whether they received allogeneic haematopoietic cell transplantation (HCT) in first clinical remission, results from the QuANTUM-First trial demonstrated.

Although allogeneic HCT in first clinical remission improves survival in patients with FLT3-ITD mutated AML, relapse rates remain high [1]. To improve outcomes for the FLT3-ITD mutated AML population, Dr Richard Schlenk (University of Heidelberg, Germany) and his team investigated the benefits of adding quizartinib, a second-generation type 2 FLT3 inhibitor, to the treatment regimen: the phase 3 QuANTUM-First study (NCT02668653) included 539 participants with FLT3-ITD mutated AML who had received standard high-dose cytarabine and/or HCT and assessed the safety and efficacy of the addition of quizartinib to standard induction and consolidation chemotherapy, followed by up to 3 years of continuation therapy with quizartinib [2]. The current analysis investigated the impact of allogeneic HCT in the first clinical remission and the interplay with quizartinib.

In total, 157 participants received allogeneic HCT in the first clinical remission. Including allogeneic HCT in first clinical remission as a time-dependent variable in a multiple regression analysis resulted in a hazard ratio of 0.42 (P<0.0001) for overall survival (OS), favouring those who had received allogeneic HCT over those who had not. On top of that, treatment with quizartinib was an independent factor for improving OS (HR 0.77; P=0.028), irrespective of whether participants had received allogeneic HCT or not.

For patients with FLT3-ITD mutated AML, quizartinib may thus present a promising treatment option substituting HCT.

 

1. Schlenk RF, et al. Blood. 2014;124(23):3441─3449
2. Schlenk RF, et al. Impact of allogeneic hematopoietic cell transplantation in first complete remission plus FLT3 inhibition with quizartinib in acute myeloid leukemia with FLT3-ITD: results from QuANTUM-First. AML clinical studies and risk stratification, EHA 2023 Annual Congress, 8─11 June, Frankfurt, Germany.

Posted on 2 August, 202318 March, 2024