Dr. Blum on the Current Treatment Landscape of Acute Myeloid Leukemia

William G. Blum, MD, professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine, director of the Acute Leukemia Program at Winship Cancer Institute, discusses the current treatment landscape of acute myeloid leukemia (AML).

In the current treatment landscape of patients with AML, about 10% to 20% of patients have IDH1/2 mutations who now have drugs that inhibit the mutated enzymes, such as enasidenib (Idhifa). While these drugs are effective, they are not curative; they elicit responses in 30% to 40% of patients when given as monotherapy. However, recent data show that adding these drugs to chemotherapy substantially increases response rates.

Another category in the treatment landscape of AML would be FLT3 inhibitors. There are 2 that are now FDA approved: midostaurin (Rydapt) and gilteritinib (Xospata). Midostaurin was first approved to be used in combination with chemotherapy because it improves survival and reduces the risk of relapse; however, transplant appears to remain an important component of treatment. Gilteritinib was another drug that was approved as a single agent for patients with relapsed disease. The field could potentially see gilteritinib in combination with both intensive and less-intensive chemotherapy but that remains in question, concludes Blum.