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FLT3 mutations in acute myeloid leukemia: a review focusing on clinically applicable drugs
Jae-Sook Ahn1,2, Hyeoung-Joon Kim1,2
1Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University, Gwangju, Korea.
Abstract:
FMS-like tyrosine kinase 3 (FLT3) mutations, the most frequently detected genetic aberrations in patients with acute myeloid leukemia (AML), are identified in approximately 30% of patients with newly diagnosed AML and are more common in patients with normal karyotypes. Since the discovery of FLT3 mutations in AML, clinical trials have been actively conducted in patients with FLT3 mutated AML, and FLT3 inhibitors have been introduced into clinical practice. The current standard treatment for patients with newly diagnosed FLT3-mutated AML is 7+3 induction chemotherapy combined with midostaurin. Additionally, gilteritinib is more effective than salvage chemotherapy for relapsed or refractory FLT3-mutated AML. Ongoing trials are expected to provide additional treatment options depending on the disease state and patient vulnerability. This review summarizes information on clinically available FLT3 inhibitors for the management of AML with FLT3 mutations.
Insights
FMS-like tyrosine kinase 3 (FLT3) mutations are common in acute myeloid leukemia (AML). This review details FLT3 inhibitors, including midostaurin and gilteritinib, for managing FLT3-mutated AML.
Area of Science:
- Hematology
- Oncology
- Molecular Biology
Background:
- FMS-like tyrosine kinase 3 (FLT3) mutations are prevalent genetic alterations in acute myeloid leukemia (AML), found in about 30% of newly diagnosed cases.
- These mutations are particularly common in AML patients with normal karyotypes.
Purpose of the Study:
- To review clinically available FMS-like tyrosine kinase 3 (FLT3) inhibitors for treating acute myeloid leukemia (AML) with FLT3 mutations.
- To summarize current and emerging treatment strategies for FLT3-mutated AML.
Main Methods:
- Literature review of clinical trials and practice guidelines.
- Analysis of data on FLT3 inhibitors in AML management.
Main Results:
- Midostaurin is part of the standard induction chemotherapy (7+3) for newly diagnosed FLT3-mutated AML.
- Gilteritinib demonstrates superior efficacy compared to salvage chemotherapy in relapsed or refractory FLT3-mutated AML.
Conclusions:
- FLT3 inhibitors represent a significant advancement in the treatment of FLT3-mutated AML.
- Ongoing research is expanding therapeutic options for patients with FLT3-mutated AML, considering disease status and patient factors.
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