In a nutshell
This study aimed to evaluate the effect of sorafenib (Nexavar) on the outcomes of patients with acute myeloid leukemia (AML) with FMS-like tyrosine kinase 3 (FLT3)–internal tandem duplication (ITD) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT).
This study concluded that sorafenib before or after transplantation, and their combined application all could improve the outcomes for these patients.
Some background
FMS-like tyrosine kinase 3 internal tandem duplication acute myeloid leukemia (FLT3-ITD AML) is a type of AML that has a specific mutation. AML patients are commonly treated with allogeneic hematopoietic stem cell transplants (allo-HSCT). These transplants involve taking stem cells from one person and transplanting them into the AML patient to allow development of new blood cells.
Sorafenib is a targeted therapy that blocks multiple causes of leukemia cells. Some evidence has shown that it is effective in patients with FLT3-ITD AML. The effect of sorafenib on surivival in patients with FLT3-ITD ALL undergoing allo-HSCT was unknown.
Methods & findings
This study involved 144 patients with FLT3-ITD AML undergoing allo-HSCT. Patients were divided into 4 groups. Group A consisted of 36 patients who received sorafenib before transplantation. Group B consisted of 32 patients who received sorafenib after transplantation. Group C consisted of 26 patients who received sorafenib both before and after transplantation. Group D consisted of 50 patients who did not receive sorafenib.
The 3-year relapse rate was 22.2% for group A, 18.8% for group B, 15.8% for group C and 46.1% for group D.
The 3-year overall survival (OS, time from treatment until death from any cause) rate was 74.9% for group A, 78.1% for group B, 84.6% for group C, and 50.9% for group D.
The 3-year leukemia-free survival (LFS, time from treatment until leukemia return) rate was 69.4% for group A, 78.1% for group B, 80.4% for group C and 34.8% for group D.
The relapse rate was higher and the LFS was shorter in group D versus groups A, B, and C. The OS in group D was shorter than the OS in group C but was similar to the OS in groups A and B.
The bottom line
This study concluded that sorafenib before or after transplantation, and their combined application all could improve the outcomes for patients with FLT3-ITD AML.
The fine print
Further study is needed to determine whether the use of sorafenib both before and after transplantation might be ideal.
Published By :
Cancer
Date :
Mar 06, 2018
