A study led by The University of Texas MD Anderson Cancer Center revealed that the investigational drug quizartinib prolonged overall survival for patients with a deadly form of acute myeloid leukemia (AML).
A study led by The University of Texas MD Anderson Cancer Center revealed that the investigational drug quizartinib prolonged overall survival for patients with a deadly form of acute myeloid leukemia (AML) linked to a genetic mutation called FMS-like internal tandem duplications (FLT3-ITD).
Findings from the Phase III trial were presented June 16 at the European Hematology Society’s 23rd Congress in Stockholm by Jorge Cortes, M.D., deputy chair and professor of Leukemia and lead investigator of the study called QUANTUM-R.
The study confirmed the efficacy and safety of quizartinib and the value of targeting FLT3-ITD with this novel agent. It is the first trial to demonstrate improved overall survival for FLT3-ITD-associated AML patients who were treatment-resistant or who relapsed after prior therapy. The study followed 367 patients for 103 weeks at which time the first analyses were conducted. Minimal side effects were observed.“Currently, there are no approved targeted therapies for patients with relapsed FLT3-ITD-associated AML, which represent a significant unmet medical need,” said Cortes. “Our findings demonstrated that patients on quizartinib alone had an estimated overall survival of 27 percent after 52 weeks of treatment compared to20 percent for patients on standard chemotherapies.”
Cortes led the multi-institutional effort to develop and test quizartinib, a small molecule receptor tyrosine kinase inhibitor (TKI) targeting ITD abnormalities within the FLT3 gene. FLT3, a receptor tyrosine kinase commonly expressed in AML, is mutated in approximately one-third of AML patients. Tyrosine kinases are enzymes often linked to cancer as they play a critical role in cellular processes including cell growth, division, differentiation and cell death.
Patients enrolled in QUANTUM-R were 18 years or older who had refractory AML or who had relapsed six months or less following complete remission after receiving standard AML therapies. The study allowed participation regardless of whether the patient had received stem cell transplantation. Patients were randomized to be administered once-daily treatments with quizartinib, or to receive one of several chemotherapy options typically used after standard treatments have failed. Chemotherapies allowed were low-dose cytarabine, the combination of mitoxantrone, etoposide, and cytarabine, or the combination of fludarabine, cytarabine and idarubicin.
The two study arms were similar in patient makeup with a median age of 55 years for patients receiving quizartinib, and 57 years for those receiving chemotherapy. Of the quizartinib group, 33 percent of patients were refractory and 67 percent had relapses after an initial complete remission of six months or less prior to the study. Thirty-four percent of patients in the chemotherapy group were refractory and 66 percent had relapsed after pre-study complete remission of six months or less.
“These pivotal data confirm that targeting FLT3-IT with this potent new therapy may be of significant clinical value,” said Cortes. “These results represent the first positive Phase III trial to demonstrate improved overall survival in patients with AML-associated FLT3-ITD.”
Other participating institutions in the study included City of Hope National Medical Center, Duarte, Calif.; Instituto Scientifico Romangolo per lo Studio e la Cura dei Tumori, Meldola, Italy; University of Pennsylvania, Philadelphia; the University of Kansas Health System, Kansas City; Nottingham University Hospital, Nottingham, U.K.; University of Heidelberg and German Cancer Research Center, Heidelberg, Germany; University Paris Diderof, Paris; Vancouver General Hospital, Vancouver, British Columbia; University of California Davis Comprehensive Cancer Center, Sacramento, Calif.; The University of Hong Kong; The University of Bristol, Bristol, U.K.; Hospital Universitari i Politécnic La Fe, Valencia, Spain; University Medical Center of Johannes Gutenberg University, Mainz, Germany; Università Cattolica del Sacro Cuore, Rome; Daiichi Sankyo, Inc., Basking Ridge, N.J.; and Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore. The study was funded by Daiichi Sankyo, Inc. Cortes serves as a consultant for the company.
