Dr. Smith on the Development of Active Therapeutic Combinations in Acute Myeloid Leukemia

Catherine Smith, MD, assistant professor, Division of Hematology/Oncology, Department of Medicine, University of California San Francisco Helen Diller Comprehensive Cancer Center, discusses developing active therapeutic combinations for the treatment of patients with acute myeloid leukemia (AML).

At the 2017 ASH Annual Meeting, researchers discussed that clinical trials have been focused on developing active therapeutic combinations. Smith cites the benefit of such an approach in the recent FDA approval and application of midostaurin (Rydapt), an inactive single agent, in combination with chemotherapy. This resulted in an increase in overall survival (OS) in a randomized upfront trial compared to chemotherapy alone, demonstrating a 7% absolute benefit in 4-year OS.

Drugs that may not be ideal alone, when combined with the right agents, may be able to produce better outcomes. Ongoing trials of these more active second-generation FLT3 inhibitors are currently accruing in the upfront setting and the relapsed/refractory setting. These include upfront combinations with gilteritinib, quizartinib, induction chemotherapy, and hypomethylating agents.