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 44th 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”.

  1. Bazarbachi A. et al. Sorafenib salvage improves overall survival of FLT3 AML patients in relapse after allogeneic hematopoietic cell transplantations: A report of the EBMT Acute Leukemia Working Party. Oral abstract #OS7-1. 2018 European Society for Blood and Marrow Transplantation (EBMT) Annual Meeting, Lisbon, PT.
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