Most Read Articles
31 May 2016
Tacrolimus is safe and effective in inducing and maintaining remission in paediatric patients with biologic refractory inflammatory bowel disease (IBD), according to a study presented at the 49th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition in Athens, Greece.
Rachel Soon, 12 Dec 2018

MIMS Pharmacist presents an overview of superoxide dismutase (SOD) and its role in resisting the effects of oxidative stress and aging.

Rachel Soon, 25 Jul 2018

MIMS Pharmacist presents an overview of Lactobacillus plantarum 299v's physiological role, as well as contemporary research on its pharmacology and effects.

01 Mar 2018
Lifetime prevalence of acute pain leading to the use of analgesics approaches 100% in the general population, and pharmacists are a pivotal first point of contact for patients in their journey to better pain management. Noting the need for pharmacists to be more aware of their evolving role as a community pharmacist, GlaxoSmithKline Consumer Healthcare partnered with MIMS Education to organize a workshop that served as a platform for robust knowledge-sharing. Below are highlights from the workshop.

Midostaurin + chemo improves OS in patients with AML and FLT3 mutation

Roshini Claire Anthony
15 Jul 2017

Adding midostaurin to standard chemotherapy appeared to improve overall survival (OS) in patients recently diagnosed with acute myeloid leukaemia (AML) with a FLT3 mutation, according to a recent study.

“[We] determined that midostaurin, a multitargeted kinase inhibitor, led to improved outcomes among younger adults with AML and a FLT3 mutation, a population with a poor prognosis that represents approximately one-fourth of all patients with AML,” said the researchers.

Seven hundred and seventeen patients (median age 47.9 years) with newly diagnosed AML (non-therapy-related) and a FLT3 mutation (either TKD* or ITD** subtype) received oral midostaurin (50 mg twice daily on days 8–21, n=360, 51.7 percent female) or placebo (n=357, 59.4 percent female) in addition to standard chemotherapy (induction therapy with intravenous daunorubicin [60 mg/m2/day on days 1, 2, and 3] and cytarabine [200 mg/m2 on days 1–7] and consolidation therapy [four 28-day cycles of cytarabine 3,000 mg/m2 over 3 hours every 12 hours on days 1, 3, and 5 after complete remission following induction therapy]).

Patients who remained in remission following consolidation therapy were continued on midostaurin or placebo for twelve 28-day cycles. Median follow-up time was 59 months.

Patients assigned to midostaurin had significantly longer OS compared with those on standard chemotherapy only (median 74.7 vs 25.6 months, hazard ratio [HR], 0.78, 95 percent confidence interval [CI], 0.63–0.96; one-sided p=0.009). At 4 years, the OS was 51.4 and 44.3 percent in the midostaurin and standard chemotherapy only groups, respectively. [N Engl J Med 2017;doi:10.1056/NEJMoa1614359]

There was no significant difference in OS rates between FLT3 subtypes, and rate of complete remission was also comparable between patients on midostaurin and standard chemotherapy only (58.9 percent vs 53.5 percent; p=0.15).

Event-free survival was longer in patients receiving midostaurin compared with those receiving standard chemotherapy only (median 8.2 vs 3.0 months, HR, 0.78, 95 percent CI, 0.66–0.93; one-sided p=0.002), as was disease-free survival (median 26.7 vs 15.5 months; p=0.01).

Incidence of grade 3, 4, or 5 (combined) adverse events was comparable between the two groups, though there was a higher incidence of grade 3, 4, or 5 anaemia and rash in the midostaurin compared with the standard chemotherapy only group (92.7 percent vs 87.8 percent; p=0.03 and 14.1 percent vs 7.6 percent; p=0.008, respectively), while the incidence of nausea was higher in the standard chemotherapy only group (9.6 percent vs 5.6 percent; p=0.05).

Fifty-seven percent of patients underwent transplantation at which point trial treatment was discontinued. After censoring data at time of transplantation, 4-year OS was longer in patients on midostaurin compared with those on standard chemotherapy only (63.7 percent vs 55.7 percent; p=0.08).

“Since exposure to the FLT3 inhibitor was relatively brief ... it is probable that the major effect ... was the early reduction of disease burden,” said the researchers, though they did not discount other potential actions. “It is possible that the benefit of midostaurin ... might lie beyond its ability to inhibit FLT3,” they said.

 

 

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Most Read Articles
31 May 2016
Tacrolimus is safe and effective in inducing and maintaining remission in paediatric patients with biologic refractory inflammatory bowel disease (IBD), according to a study presented at the 49th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition in Athens, Greece.
Rachel Soon, 12 Dec 2018

MIMS Pharmacist presents an overview of superoxide dismutase (SOD) and its role in resisting the effects of oxidative stress and aging.

Rachel Soon, 25 Jul 2018

MIMS Pharmacist presents an overview of Lactobacillus plantarum 299v's physiological role, as well as contemporary research on its pharmacology and effects.

01 Mar 2018
Lifetime prevalence of acute pain leading to the use of analgesics approaches 100% in the general population, and pharmacists are a pivotal first point of contact for patients in their journey to better pain management. Noting the need for pharmacists to be more aware of their evolving role as a community pharmacist, GlaxoSmithKline Consumer Healthcare partnered with MIMS Education to organize a workshop that served as a platform for robust knowledge-sharing. Below are highlights from the workshop.