- Phase 2 trial enrolled 44 patients with FLT3-mutant acute myeloid leukemia
- Combination of crenolanib and standard chemotherapy was safe and effective
- This combination could become new standard of care; phase 3 trial enrolling
In this multicenter Roswell Park-led clinical trial, 44 patients with newly diagnosed FLT3-mutant AML received standard front-line induction chemotherapy with cytarabine for 7 days and daunorubicin or idarubicin for 3 days. Starting on day 9, crenolanib, which is an active inhibitor of FLT3– ITD, TKD and variant AML mutations, was administered three times per day until 3 days before the next chemotherapy treatment. Most patients (75%) had FLT3-ITD mutations, 8 patients (18%) had TKD mutations, and 3 patients (7%) had both ITD and TKD mutations.
After one treatment cycle, 73% of patients experienced clinical responses, and 86% of patients responded to treatment after two cycles. Better responses were noted in younger patients (≤ 60 years) and those with FLT3-ITD mutations.
“Our results were highly promising, with more than 80% of patients who received the crenolanib chemotherapy combination achieving clinical responses after treatment, and more than half still alive after almost 4 years,” says Dr. Wang, principal investigator of the clinical trial and senior author of the study. “We believe that addition of this next-generation FLT3 inhibitor to conventional chemotherapy could significantly improve outcomes and become the new standard of care for patients with FLT3-mutant AML.”
The most common treatment-related adverse events were diarrhea, nausea and febrile neutropenia, and six patients required crenolanib dose reduction during treatment. Approximately 15% of patients experienced disease relapse, but mutational analysis in these patients showed clearance of multiple FLT3 mutations and no new FLT3 clones.
A larger, phase 3 clinical trial (NCT03258931) randomizing patients with newly diagnosed FLT3-mutant AML to receive either crenolanib or midostaurin is underway at 31 sites and currently enrolling patients at Roswell Park.
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This release is also available at: https://www.roswellpark.org/newsroom/202206-roswell-park-expert-present-effectiveness-new-combination-acute-myeloid-leukemia
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