Oral targeted agent versus chemotherapy in acute myeloid leukaemia

Mené sur 367 patients atteints d'une leucémie myéloïde aiguë réfractaire ou récidivante, cet essai de phase III compare l'efficacité, du point de vue de la survie globale, et la toxicité du quizartinib (un inhibiteur anti-FLT3 de type II) et une chimiothérapie de sauvetage choisie par le médecin (durée médiane de suivi : 23,5 mois)

Résumé en anglais

In The Lancet Oncology, Jorge E Cortes and colleagues present the results of the QuANTUM-R trial, a randomised comparison between the second-generation tyrosine kinase inhibitor quizartinib and standard of care chemotherapy in patients with relapsed or refractory acute myeloid leukaemia carrying an FLT3 internal tandem duplication ( FLT3-ITD) mutation. In this difficult clinical situation, patients treated with quizartinib survived for longer than those who received standard chemotherapy. Although the improvement in median survival across all enrolled patients was moderate (6·2 months for quizartinib vs 4·7 months for chemotherapy), the results are a substantial step forward in the treatment of acute myeloid leukaemia, since they represent the first published (with the exception of meeting abstracts) randomised evidence that tyrosine kinase inhibition by a single agent can be more efficacious than standard chemotherapy