Zeidan Amer M, Yu Rebekah, Wang Yuexi, Lan Ziyu, Grinblatt David L, Elsouda Dina, Spalding James, Block Alana, Touya Maelys, Walker Mark S, Pandya Bhavik J
Department of Hematology, Yale School of Medicine and Yale Cancer Center, New Haven, Connecticut, USA.
Real World Evidence, ConcertAI, LLC, Cambridge, Massachusetts, USA.
Acta Haematol. 2025 Apr 14:1-12. doi: 10.1159/000545384.
Recent advances in genomic research have expanded the treatment landscape for acute myeloid leukemia (AML). This study examined treatment patterns and clinical outcomes among relapsed/refractory (R/R) FMS-like tyrosine kinase 3 (FLT3)-mutated AML patients.
This retrospective longitudinal study included patients with confirmed AML diagnosis, FLT3 mutation, and 1st R/R event from 1/1/2015 to 1/31/2023 in the ConcertAI Oncology Dataset. Treatment patterns, FLT3 testing rates, real-world overall survival (rwOS), and real-world time to next treatment (rwTTNT) were studied.
Among the 336 treated patients, 50.6% received FLT3-tyrosine kinase inhibitors (FLT3-TKIs) as first treatment after R/R event, of which 51.8% received gilteritinib. High-intensity chemotherapy used as first treatment after R/R event decreased from 67.9% in 2015 to 20.0% in 2022, while FLT3-TKI utilization rose to 50% over the same period. Among the 246 patients tested for FLT3 at initial AML diagnosis, only 36% were retested at 1st R/R event. Median rwOS and rwTTNT among FLT3-TKI patients were 12.4 months and 2.9 months, respectively.
This study reveals a trend toward increasing FLT3-TKI use and highlights the need for repeated FLT3 testing among R/R AML patients. Real-world evidence is vital in understanding R/R AML patient care amidst emerging therapies.
基因组研究的最新进展拓展了急性髓系白血病(AML)的治疗格局。本研究调查了复发/难治性(R/R)FMS样酪氨酸激酶3(FLT3)突变的AML患者的治疗模式和临床结局。
这项回顾性纵向研究纳入了ConcertAI肿瘤学数据集中2015年1月1日至2023年1月31日确诊为AML、存在FLT3突变且发生首次R/R事件的患者。研究了治疗模式、FLT3检测率、真实世界总生存期(rwOS)和真实世界下次治疗时间(rwTTNT)。
在336例接受治疗的患者中,50.6%在R/R事件后首次接受FLT3酪氨酸激酶抑制剂(FLT3-TKIs)治疗,其中51.8%接受了吉瑞替尼治疗。R/R事件后作为首次治疗的高强度化疗从2015年的67.9%降至2022年的20.0%,而同期FLT3-TKI的使用率升至50%。在246例初诊AML时检测FLT3的患者中,只有36%在首次R/R事件时进行了重新检测。FLT3-TKI治疗患者的rwOS和rwTTNT中位数分别为12.4个月和2.9个月。
本研究揭示了FLT3-TKI使用增加的趋势,并强调了R/R AML患者重复进行FLT3检测的必要性。在新兴疗法中,真实世界证据对于理解R/R AML患者的治疗至关重要。