What research is being done with gliteritinib to make this therapy more effective?

So investigators are evaluating
the use of a FLT3 inhibitor

with other targeted therapies, intensive
chemotherapy and immunotherapeutic approaches.

So, for example, the use of gilteritinib
with the BCL-2 inhibitor venetoclax has shown

So, for example, the use of gilteritinib
with the BCL-2 inhibitor venetoclax has shown

an 80% response rate in patients
with relapsed refractory FLT3

mutated acute myeloid leukemia.

It's also being evaluated in combination
with intensive chemotherapy

It's also being evaluated in combination
with intensive chemotherapy

compared to intensive chemotherapy
with midostaurin in patients

with FLT3 mutated AML
that are previously untreated.

with FLT3 mutated AML
that are previously untreated.

And of course, other inhibitors will be developed
with FLT3 inhibitors, for example,

nucleophosmin mutations
quite commonly occur with FLT3 ITD mutations.

Menin inhibitors have shown single agent activity
in patients with acute myeloid leukemia,

with nucleophosmin and or NPM1 mutations
and clinical trials are being designed,

and some have already started with menin
inhibitors in combination with a FLT3 inhibitor

such as gilteritinib patients
with relapsed refractory AML that have both a FLT3

and a nucleophosmin mutation.

FLT3 is a one of the three most common mutations

that are found in acute myeloid leukemia
and are part of leukemogenesis,

and so it makes sense that multiple inhibitors
have been developed

that target FLT3
and in general have shown single agent activity.

I think the— it's fair to say
that the three FLT3 inhibitors that are the furthest

along in clinical development of acute
myeloid leukemia are gilteritinib

quizartinib and crenolanib.

Now these are all second generation
more specific and more potent FLT3 inhibitors

compared to drugs like the first generation
midostaurin, which is already approved.

And so those FLT3 inhibitors are being,

all of them are being studied in combinations
with chemotherapy,

other targeted inhibitors such as BCL-2
inhibitor venetoclax with less intensive therapy

such as the hypomethylating agents
and with immunotherapeutic approaches.

At this year's Congress EHA 2022,
I am presenting the results of

the Quantum First study
where we showed that the addition of quizartinib,

a second generation type two inhibitor of FLT3

ITD, has shown a survival
benefit compared to placebo in patients

up to the age of 75 with FLT3
ITD mutated acute myeloid leukemia.

So there are definitely other FLT3
inhibitors in development.

There's a drug called quizartinib

that is being the results of a clinical trial are
being presented at this this year's EHA meeting.

I think it's being presented tomorrow.

That's a study of quizartinib in combination
with chemotherapy.

We'll have to see
what the results of that trial are.

In terms of whether anything is
better than gilteritinib, I'm not sure.

I think gilteritinib is very potent.

I'm not sure there's anything
that's that's actually better out there

that's being investigated.

I think the question is going to be

is the efficacy of gilteritinib in combination
with chemotherapy

going to be similar to the efficacy of a drug
like quizartinib with chemotherapy?