Antifungal Prophylaxis in Acute Myeloid Leukemia: New Drugs, New Challenges?

Stemler, Jannik; Cornely, Oliver A.

doi:10.1097/hs9.0000000000000742

Cited by 3 publications

(1 citation statement)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, how interactions between azoles and gilteritinib impact toxicities is not yet fully defined. Therefore, the European Hematology Association guideline on antifungal prophylaxis in patients with AML treated with novel-targeted therapies recommended triazole antifungal prophylaxis for patients who are heavily pretreated with gilteritinib [50].…”

Section: Antifungal Prophylaxis In Patients Treated With Gilteritinibmentioning

confidence: 99%

Gilteritinib: The Story of a Proceeding Success into Hard-to-Treat FLT3-Mutated AML Patients

Molica

Perrone

Rossi

2023

JCM

View full text Add to dashboard Cite

The traditionally dismal outcome of acute myeloid leukemia (AML) patients carrying the FMS-related tyrosine kinase 3 (FLT3) mutations has been mitigated by the recent introduction of tyrosine kinase inhibitors (TKI) into clinics, such as midostaurin and gilteritinib. The present work summarizes the clinical data that led to the use of gilteritinib in clinical practice. Gilteritinib is a second-generation TKI with deeper single-agent activity than first-generation drugs against both FLT3FLT3–ITD and TKD mutations in human studies. Moreover, the phase I/II dose-escalation, dose-expansion Chrysalis trial showed an acceptable safety profile of gilteritinib (diarrhea, elevated aspartate aminotransferase, febrile neutropenia, anemia, thrombocytopenia, sepsis, and pneumonia) and a 49% overall response rate (ORR) in 191 FLT3FLT3-mutated relapsed/refractory (R/R) AML patients. In 2019, the pivotal ADMIRAL trial showed that the median overall survival was significantly longer in patients treated with gilteritinib than among those receiving chemotherapy (9.3 vs. 5.6 months, respectively) and the ORR to gilteritinib was 67.6%, outperforming the 25.8% for chemotherapy arm and leading to the license for its clinical use by the US Food and Drug Administration. Since then, several real-world experiences have confirmed the positive results in the R/R AML setting. Finally, gilteritinib-based combinations currently under investigation, with several compounds (venetoclax, azacitidine, conventional chemotherapy, etc.) and some practical tips (maintenance after allogeneic transplantation, interaction with antifungal drugs, extramedullary disease, and onset of resistance), will be analyzed in detail in this review.

show abstract

Section: Antifungal Prophylaxis In Patients Treated With Gilteritinibmentioning

confidence: 99%