STREAMLINE - Retrospective cohort study of FMS-like tyrosine kinase 3-mutated acute myeloid leukemia: Real-world treatment patterns and clinical outcomes of patients in first relapse or refractory diagnosis

This retrospective longitudinal study included patients with confirmed AML diagnosis, FLT3 mutation, and 1st R/R event from 1/1/2015 to 1/31/2023 in the ConcertAI Oncology Dataset. Treatment patterns, FLT3 testing rates, real-world overall survival (rwOS), and real-world time to next treatment (rwTTNT) were studied.

Among the 336 treated patients, 50.6% received FLT3-tyrosine kinase inhibitors (FLT3-TKIs) as first treatment after R/R event, of which 51.8% received gilteritinib. High-intensity chemotherapy used as first treatment after R/R event decreased from 67.9% in 2015 to 20.0% in 2022, while FLT3-TKI utilization rose to 50% over the same period. Among the 246 patients tested for FLT3 at initial AML diagnosis, only 36% were retested at 1st R/R event. Median rwOS and rwTTNT among FLT3-TKI patients were 12.4 months and 2.9 months, respectively.

This study reveals a trend toward increasing FLT3-TKI use and highlights the need for repeated FLT3 testing among R/R AML patients. Real-world evidence is vital in understanding R/R AML patient care amidst emerging therapies.