EBMT 2018 | Salvage therapy with sorafenib improves survival of FLT3-mutated AML patients experiencing relapse after allo-HCT

Sorafenib is an effective salvage therapy for patients with fms like tyrosine kinase 3 (FLT3) mutated acute myeloid leukemia (AML) patients relapsing or progressing after allogeneic hematopoietic cell transplantation (allo-HCT) according to a study presented by Ali Bazarbachi, from the American University of Beirut Medical Center, Beirut, LB, and colleagues at the 44^th Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), Lisbon, Portugal.¹

In this retrospective registry-based analysis, Bazarbachi and colleagues identified 158 FLT3-mutated AML patients who underwent allo-HCT between 2012–2015 at EBMT participating centers who relapsed or progressed after allo-HCT. Patients were transplanted either in first complete remission (CR1, n = 92), second CR (CR2, n = 18), third CR (CR3, n = 1) or with active disease (n = 47). Salvage sorafenib therapy was administered to 34 patients relapsing or progressing after allo-HCT (sorafenib group). For this analysis, patients administered sorafenib salvage therapy were compared to patients who did not receive sorafenib salvage therapy (no-sorafenib group, n = 124).

With a median follow-up time of 23 months (range, 4–68) after relapse for surviving patients, it was observed that sorafenib administered for relapse significantly improved the overall survival (OS, HR = 0.48, P = 0.006). Paired matched analysis of patients in the sorafenib (n = 25) and no-sorafenib (n = 25) group demonstrated that compared to the control group, sorafenib significantly improved OS (2-year OS, 30% vs 14%, P = 0.0015).

The speaker, Ali Bazarbachi, concluded by stating that “sorafenib is a safe and effective salvage therapy for patients with FLT3 mutated AML relapsing or progressing after allo-HCT leading to a significant improvement of OS”.