Efficacy and safety of quizartinib in Japanese patients with FLT3-ITD positive relapsed or refractory acute myeloid leukemia in an open-label, phase 2 study
FMS-like tyrosine kinase 3 ( FLT3 ) internal tandem duplication (ITD) mutations in patients with acute myeloid leukemia (AML) are associated with early relapse and poor survival. This multicenter, single-arm, two-stage phase 2 study (NCT02984995) was conducted to evaluate the efficacy and safety of...
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Veröffentlicht in: | International journal of hematology 2019-12, Vol.110 (6), p.665-674 |
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creator | Takahashi, Takeshi Usuki, Kensuke Matsue, Kosei Ohno, Hitoshi Sakura, Toru Imanaka, Ryota Murakami, Masato Ohwada, Shoichi Takagi, Taiga Sakajiri, Sakura |
description | FMS-like tyrosine kinase 3 (
FLT3
) internal tandem duplication (ITD) mutations in patients with acute myeloid leukemia (AML) are associated with early relapse and poor survival. This multicenter, single-arm, two-stage phase 2 study (NCT02984995) was conducted to evaluate the efficacy and safety of quizartinib hydrochloride (initial dose 20/30 mg/day), an oral, highly potent, selective
FLT3
inhibitor in Japanese patients (median age 65 years) with
FLT3
-ITD positive relapsed/refractory (R/R) AML. The composite complete remission (CRc) rate (primary endpoint) was 53.8% (90% confidence interval 36.2–70.8%) for evaluable patients in the efficacy analysis set. The median duration of CRc and overall survival was 16.1 weeks and 34.1 weeks, respectively. The most frequent treatment-emergent adverse events (TEAEs) were febrile neutropenia (43.2%), platelet count decreased (37.8%), and QT prolonged (35.1%). Two (5.4%) patients experienced TEAEs associated with treatment discontinuation. All serious TEAEs (45.9%), except febrile neutropenia (16.2%), were reported in ≤ 2 patients. The incidence of QTcF 451–480 ms and 481–500 ms was 37.8% and 2.7%, respectively. No QTcF > 500 ms, events of torsade de pointes or arrhythmia with clinical symptoms were reported. Quizartinib monotherapy was well tolerated and resulted in clinically meaningful reductions in blast count in Japanese patients with
FLT3
-ITD R/R AML. |
doi_str_mv | 10.1007/s12185-019-02727-6 |
format | Article |
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FLT3
) internal tandem duplication (ITD) mutations in patients with acute myeloid leukemia (AML) are associated with early relapse and poor survival. This multicenter, single-arm, two-stage phase 2 study (NCT02984995) was conducted to evaluate the efficacy and safety of quizartinib hydrochloride (initial dose 20/30 mg/day), an oral, highly potent, selective
FLT3
inhibitor in Japanese patients (median age 65 years) with
FLT3
-ITD positive relapsed/refractory (R/R) AML. The composite complete remission (CRc) rate (primary endpoint) was 53.8% (90% confidence interval 36.2–70.8%) for evaluable patients in the efficacy analysis set. The median duration of CRc and overall survival was 16.1 weeks and 34.1 weeks, respectively. The most frequent treatment-emergent adverse events (TEAEs) were febrile neutropenia (43.2%), platelet count decreased (37.8%), and QT prolonged (35.1%). Two (5.4%) patients experienced TEAEs associated with treatment discontinuation. All serious TEAEs (45.9%), except febrile neutropenia (16.2%), were reported in ≤ 2 patients. The incidence of QTcF 451–480 ms and 481–500 ms was 37.8% and 2.7%, respectively. No QTcF > 500 ms, events of torsade de pointes or arrhythmia with clinical symptoms were reported. Quizartinib monotherapy was well tolerated and resulted in clinically meaningful reductions in blast count in Japanese patients with
FLT3
-ITD R/R AML.</description><identifier>ISSN: 0925-5710</identifier><identifier>EISSN: 1865-3774</identifier><identifier>DOI: 10.1007/s12185-019-02727-6</identifier><identifier>PMID: 31473943</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Acute myeloid leukemia ; Aged ; Arrhythmia ; Benzothiazoles - adverse effects ; Benzothiazoles - pharmacology ; Benzothiazoles - therapeutic use ; Confidence intervals ; Effectiveness ; Female ; Flt3 protein ; fms-Like Tyrosine Kinase 3 - genetics ; Hematology ; Humans ; Japan ; Kinases ; Leukemia ; Leukemia, Myeloid, Acute - complications ; Leukemia, Myeloid, Acute - drug therapy ; Leukemia, Myeloid, Acute - mortality ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mutation ; Myeloid leukemia ; Neutropenia ; Oncology ; Original Article ; Patients ; Phenylurea Compounds - adverse effects ; Phenylurea Compounds - pharmacology ; Phenylurea Compounds - therapeutic use ; Protein Kinase Inhibitors - therapeutic use ; Protein-tyrosine kinase ; Remission ; Remission Induction - methods ; Safety ; Salvage Therapy - adverse effects ; Salvage Therapy - methods ; Salvage Therapy - mortality ; Survival ; Treatment Outcome ; Tyrosine</subject><ispartof>International journal of hematology, 2019-12, Vol.110 (6), p.665-674</ispartof><rights>Japanese Society of Hematology 2019</rights><rights>International Journal of Hematology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-2150b732d0b82b19b2a0bb4be11b5483615cb17e37e6729a5b166b5ea889e3243</citedby><cites>FETCH-LOGICAL-c399t-2150b732d0b82b19b2a0bb4be11b5483615cb17e37e6729a5b166b5ea889e3243</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12185-019-02727-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12185-019-02727-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31473943$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takahashi, Takeshi</creatorcontrib><creatorcontrib>Usuki, Kensuke</creatorcontrib><creatorcontrib>Matsue, Kosei</creatorcontrib><creatorcontrib>Ohno, Hitoshi</creatorcontrib><creatorcontrib>Sakura, Toru</creatorcontrib><creatorcontrib>Imanaka, Ryota</creatorcontrib><creatorcontrib>Murakami, Masato</creatorcontrib><creatorcontrib>Ohwada, Shoichi</creatorcontrib><creatorcontrib>Takagi, Taiga</creatorcontrib><creatorcontrib>Sakajiri, Sakura</creatorcontrib><title>Efficacy and safety of quizartinib in Japanese patients with FLT3-ITD positive relapsed or refractory acute myeloid leukemia in an open-label, phase 2 study</title><title>International journal of hematology</title><addtitle>Int J Hematol</addtitle><addtitle>Int J Hematol</addtitle><description>FMS-like tyrosine kinase 3 (
FLT3
) internal tandem duplication (ITD) mutations in patients with acute myeloid leukemia (AML) are associated with early relapse and poor survival. This multicenter, single-arm, two-stage phase 2 study (NCT02984995) was conducted to evaluate the efficacy and safety of quizartinib hydrochloride (initial dose 20/30 mg/day), an oral, highly potent, selective
FLT3
inhibitor in Japanese patients (median age 65 years) with
FLT3
-ITD positive relapsed/refractory (R/R) AML. The composite complete remission (CRc) rate (primary endpoint) was 53.8% (90% confidence interval 36.2–70.8%) for evaluable patients in the efficacy analysis set. The median duration of CRc and overall survival was 16.1 weeks and 34.1 weeks, respectively. The most frequent treatment-emergent adverse events (TEAEs) were febrile neutropenia (43.2%), platelet count decreased (37.8%), and QT prolonged (35.1%). Two (5.4%) patients experienced TEAEs associated with treatment discontinuation. All serious TEAEs (45.9%), except febrile neutropenia (16.2%), were reported in ≤ 2 patients. The incidence of QTcF 451–480 ms and 481–500 ms was 37.8% and 2.7%, respectively. No QTcF > 500 ms, events of torsade de pointes or arrhythmia with clinical symptoms were reported. Quizartinib monotherapy was well tolerated and resulted in clinically meaningful reductions in blast count in Japanese patients with
FLT3
-ITD R/R AML.</description><subject>Acute myeloid leukemia</subject><subject>Aged</subject><subject>Arrhythmia</subject><subject>Benzothiazoles - adverse effects</subject><subject>Benzothiazoles - pharmacology</subject><subject>Benzothiazoles - therapeutic use</subject><subject>Confidence intervals</subject><subject>Effectiveness</subject><subject>Female</subject><subject>Flt3 protein</subject><subject>fms-Like Tyrosine Kinase 3 - genetics</subject><subject>Hematology</subject><subject>Humans</subject><subject>Japan</subject><subject>Kinases</subject><subject>Leukemia</subject><subject>Leukemia, Myeloid, Acute - complications</subject><subject>Leukemia, Myeloid, Acute - drug therapy</subject><subject>Leukemia, Myeloid, Acute - mortality</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Myeloid leukemia</subject><subject>Neutropenia</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Phenylurea Compounds - adverse effects</subject><subject>Phenylurea Compounds - pharmacology</subject><subject>Phenylurea Compounds - therapeutic use</subject><subject>Protein Kinase Inhibitors - therapeutic use</subject><subject>Protein-tyrosine kinase</subject><subject>Remission</subject><subject>Remission Induction - methods</subject><subject>Safety</subject><subject>Salvage Therapy - adverse effects</subject><subject>Salvage Therapy - methods</subject><subject>Salvage Therapy - mortality</subject><subject>Survival</subject><subject>Treatment Outcome</subject><subject>Tyrosine</subject><issn>0925-5710</issn><issn>1865-3774</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc1u1TAQRi1ERW8LL8ACWWLDoi7-iWNniUoLra7E5rK27GRCXZI4tZ2i8Cw8LG5vAYlFV7bkM2fG8yH0mtFTRql6nxhnWhLKGkK54orUz9CG6VoSoVT1HG1owyWRitFDdJTSDaVM0Uq9QIeCVUo0ldigX-d971vbrthOHU62h7zi0OPbxf-0MfvJO-wnfGVnO0ECPNvsYcoJ__D5Gl9sd4Jc7j7iOSSf_R3gCIOdE3Q4xHLvo21ziEXeLhnwuMIQfIcHWL7D6O292U44zDCRwToYTvB8bUsXjlNeuvUlOujtkODV43mMvl6c784-k-2XT5dnH7akFU2TCWeSOiV4R53mjjWOW-pc5YAxJystaiZbxxQIBbXijZWO1bWTYLVuQPBKHKN3e-8cw-0CKZvRpxaGofw5LMlwroUoq9a8oG__Q2_CEqcy3QNFdVNxWSi-p9oYUip7MHP0o42rYdTcZ2f22ZmSnXnIztSl6M2jenEjdH9L_oRVALEHUnmavkH81_sJ7W8EnKTC</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>Takahashi, Takeshi</creator><creator>Usuki, Kensuke</creator><creator>Matsue, Kosei</creator><creator>Ohno, Hitoshi</creator><creator>Sakura, Toru</creator><creator>Imanaka, Ryota</creator><creator>Murakami, Masato</creator><creator>Ohwada, Shoichi</creator><creator>Takagi, Taiga</creator><creator>Sakajiri, Sakura</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20191201</creationdate><title>Efficacy and safety of quizartinib in Japanese patients with FLT3-ITD positive relapsed or refractory acute myeloid leukemia in an open-label, phase 2 study</title><author>Takahashi, Takeshi ; Usuki, Kensuke ; Matsue, Kosei ; Ohno, Hitoshi ; Sakura, Toru ; Imanaka, Ryota ; Murakami, Masato ; Ohwada, Shoichi ; Takagi, Taiga ; Sakajiri, Sakura</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-2150b732d0b82b19b2a0bb4be11b5483615cb17e37e6729a5b166b5ea889e3243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acute myeloid leukemia</topic><topic>Aged</topic><topic>Arrhythmia</topic><topic>Benzothiazoles - adverse effects</topic><topic>Benzothiazoles - pharmacology</topic><topic>Benzothiazoles - therapeutic use</topic><topic>Confidence intervals</topic><topic>Effectiveness</topic><topic>Female</topic><topic>Flt3 protein</topic><topic>fms-Like Tyrosine Kinase 3 - genetics</topic><topic>Hematology</topic><topic>Humans</topic><topic>Japan</topic><topic>Kinases</topic><topic>Leukemia</topic><topic>Leukemia, Myeloid, Acute - complications</topic><topic>Leukemia, Myeloid, Acute - drug therapy</topic><topic>Leukemia, Myeloid, Acute - mortality</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Myeloid leukemia</topic><topic>Neutropenia</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Phenylurea Compounds - adverse effects</topic><topic>Phenylurea Compounds - pharmacology</topic><topic>Phenylurea Compounds - therapeutic use</topic><topic>Protein Kinase Inhibitors - therapeutic use</topic><topic>Protein-tyrosine kinase</topic><topic>Remission</topic><topic>Remission Induction - methods</topic><topic>Safety</topic><topic>Salvage Therapy - adverse effects</topic><topic>Salvage Therapy - methods</topic><topic>Salvage Therapy - mortality</topic><topic>Survival</topic><topic>Treatment Outcome</topic><topic>Tyrosine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takahashi, Takeshi</creatorcontrib><creatorcontrib>Usuki, Kensuke</creatorcontrib><creatorcontrib>Matsue, Kosei</creatorcontrib><creatorcontrib>Ohno, Hitoshi</creatorcontrib><creatorcontrib>Sakura, Toru</creatorcontrib><creatorcontrib>Imanaka, Ryota</creatorcontrib><creatorcontrib>Murakami, Masato</creatorcontrib><creatorcontrib>Ohwada, Shoichi</creatorcontrib><creatorcontrib>Takagi, Taiga</creatorcontrib><creatorcontrib>Sakajiri, Sakura</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takahashi, Takeshi</au><au>Usuki, Kensuke</au><au>Matsue, Kosei</au><au>Ohno, Hitoshi</au><au>Sakura, Toru</au><au>Imanaka, Ryota</au><au>Murakami, Masato</au><au>Ohwada, Shoichi</au><au>Takagi, Taiga</au><au>Sakajiri, Sakura</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and safety of quizartinib in Japanese patients with FLT3-ITD positive relapsed or refractory acute myeloid leukemia in an open-label, phase 2 study</atitle><jtitle>International journal of hematology</jtitle><stitle>Int J Hematol</stitle><addtitle>Int J Hematol</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>110</volume><issue>6</issue><spage>665</spage><epage>674</epage><pages>665-674</pages><issn>0925-5710</issn><eissn>1865-3774</eissn><abstract>FMS-like tyrosine kinase 3 (
FLT3
) internal tandem duplication (ITD) mutations in patients with acute myeloid leukemia (AML) are associated with early relapse and poor survival. This multicenter, single-arm, two-stage phase 2 study (NCT02984995) was conducted to evaluate the efficacy and safety of quizartinib hydrochloride (initial dose 20/30 mg/day), an oral, highly potent, selective
FLT3
inhibitor in Japanese patients (median age 65 years) with
FLT3
-ITD positive relapsed/refractory (R/R) AML. The composite complete remission (CRc) rate (primary endpoint) was 53.8% (90% confidence interval 36.2–70.8%) for evaluable patients in the efficacy analysis set. The median duration of CRc and overall survival was 16.1 weeks and 34.1 weeks, respectively. The most frequent treatment-emergent adverse events (TEAEs) were febrile neutropenia (43.2%), platelet count decreased (37.8%), and QT prolonged (35.1%). Two (5.4%) patients experienced TEAEs associated with treatment discontinuation. All serious TEAEs (45.9%), except febrile neutropenia (16.2%), were reported in ≤ 2 patients. The incidence of QTcF 451–480 ms and 481–500 ms was 37.8% and 2.7%, respectively. No QTcF > 500 ms, events of torsade de pointes or arrhythmia with clinical symptoms were reported. Quizartinib monotherapy was well tolerated and resulted in clinically meaningful reductions in blast count in Japanese patients with
FLT3
-ITD R/R AML.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>31473943</pmid><doi>10.1007/s12185-019-02727-6</doi><tpages>10</tpages></addata></record> |
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subjects | Acute myeloid leukemia Aged Arrhythmia Benzothiazoles - adverse effects Benzothiazoles - pharmacology Benzothiazoles - therapeutic use Confidence intervals Effectiveness Female Flt3 protein fms-Like Tyrosine Kinase 3 - genetics Hematology Humans Japan Kinases Leukemia Leukemia, Myeloid, Acute - complications Leukemia, Myeloid, Acute - drug therapy Leukemia, Myeloid, Acute - mortality Male Medicine Medicine & Public Health Middle Aged Mutation Myeloid leukemia Neutropenia Oncology Original Article Patients Phenylurea Compounds - adverse effects Phenylurea Compounds - pharmacology Phenylurea Compounds - therapeutic use Protein Kinase Inhibitors - therapeutic use Protein-tyrosine kinase Remission Remission Induction - methods Safety Salvage Therapy - adverse effects Salvage Therapy - methods Salvage Therapy - mortality Survival Treatment Outcome Tyrosine |
title | Efficacy and safety of quizartinib in Japanese patients with FLT3-ITD positive relapsed or refractory acute myeloid leukemia in an open-label, phase 2 study |
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