Current Treatment Strategies for FLT3-Mutated Acute Myeloid Leukemia in Patients not Candidates for Intensive Chemotherapy.

IF 5 2区医学 Q1 ONCOLOGY

Current Oncology Reports Pub Date : 2025-09-01 Epub Date: 2025-08-01 DOI:10.1007/s11912-025-01709-8

Alex Bataller, Nicholas J Short, Naval Daver, Musa Yilmaz, Hagop Kantarjian, Farhad Ravandi

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引用次数: 0

Abstract

Purpose of review: Younger patients with acute myeloblastic leukemia with FLT3 mutations (FLT3-mutated AML) benefit from the addition of FLT3 inhibitors to intensive chemotherapy. However, patients who are not eligible for intensive chemotherapy have poor outcomes with standard low-intensity treatments. In this review we assess the current state of treatment strategies for patients with FLT3-mutated AML who are not candidates for intensive chemotherapy.

Recent findings: The addition of FLT3 inhibitors to standard low-intensity AML treatments (doublet) has increased response rates, although in a randomized clinical trial this did not improve survival. The addition of venetoclax to these regimens (triplet) shows promising activity (overall response rate of approximately 90%). However, myelotoxicity is common, and dose adjustments are usually necessary. Combinations of low-intensity treatments with venetoclax and potent FLT3 inhibitors are feasible and have shown encouraging outcomes. Dose adjustments are essential to reduce treatment-related myelosuppression.

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不适合强化化疗的flt3突变急性髓系白血病患者的当前治疗策略

回顾目的：FLT3突变的急性髓母细胞白血病（FLT3突变AML）的年轻患者受益于在强化化疗中添加FLT3抑制剂。然而，不符合强化化疗条件的患者采用标准低强度治疗的结果较差。在这篇综述中，我们评估了flt3突变AML患者的治疗策略现状，这些患者不适合进行强化化疗。最近的研究发现：在标准的低强度AML治疗（双药治疗）中添加FLT3抑制剂增加了应答率，尽管在一项随机临床试验中，这并没有提高生存率。在这些方案中加入venetoclax（三联用药）显示出有希望的活性（总有效率约为90%）。然而，骨髓毒性是常见的，通常需要调整剂量。低强度治疗联合venetoclax和强效FLT3抑制剂是可行的，并显示出令人鼓舞的结果。剂量调整对于减少治疗相关的骨髓抑制至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Oncology Reports ONCOLOGY-

CiteScore

8.50

自引率

0.00%

发文量

187

审稿时长

6-12 weeks

期刊介绍： This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.