FLT3 Inhibition in Acute Myeloid Leukaemia - Current Knowledge and Future Prospects

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Activating mutations of FMS-like tyrosine kinase 3 (FLT3) are present in 30% of acute myeloid leukaemia (AML) patients at diagnosis and confer an adverse clinical prognosis. Mutated FLT3 has emerged as a viable therapeutic target and a number of FLT3-directed tyrosine kinase inhibitors have progressed through clinical development over the last 10-15 years. The last two years have seen United States Food and Drug Administration (US FDA) approvals of the multi-kinase inhibitor midostaurin for newly-diagnosed FLT3-mutated patients, when used in combination with intensive chemotherapy, and of the more FLT3-selective agent gilteritinib, used as monotherapy, for patients with relapsed or treatment-refractory FLT3-mutated AML. The 'second generation' agents, quizartinib and crenolanib, are also at advanced stages of clinical development. Significant challenges remain in negotiating a variety of potential acquired drug resistance mechanisms and in optimizing sequencing of FLT3 inhibitory drugs with existing and novel treatment approaches in different clinical settings, including frontline therapy, relapsed/refractory disease, and maintenance treatment. In this review, the biology of FLT3, the clinical challenge posed by FLT3-mutated AML, the developmental history of the key FLT3-inhibitory compounds, mechanisms of disease resistance, and the future outlook for this group of agents, including current and planned clinical trials, is discussed.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:20

Enthalten in:

Current cancer drug targets - 20(2020), 7 vom: 18., Seite 513-531

Sprache:

Englisch

Beteiligte Personen:

Hogan, Francesca L [VerfasserIn]
Williams, Victoria [VerfasserIn]
Knapper, Steven [VerfasserIn]

Links:

Volltext

Themen:

Acute myeloid leukaemia (AML)
Antineoplastic Agents
Chemotherapy
EC 2.7.10.1
FLT3 inhibitor
FLT3 protein, human
Fms-Like Tyrosine Kinase 3
Gilteritinib main text
Journal Article
Midostaurin
Protein Kinase Inhibitors
Quizartinib
Review

Anmerkungen:

Date Completed 07.07.2021

Date Revised 07.07.2021

published: Print

Citation Status MEDLINE

doi:

10.2174/1570163817666200518075820

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM310011639