UPTAKE OF FLT3 INHIBITORS AND IMPACT ON OVERALL SURVIVAL IN PATIENTS WITH ACUTE MYELOID LEUKEMIA IN SWEDEN
Author(s)
Maria Berner, MMed1, Alexander Rieem Dun, MEcon2, Kelvin Kwok, PhD2, Christian Kjellander, MD PhD1, Tina Jacob, PhD2.
1Karolinska Institutet, Stockholm, Sweden, 2Ciencia Research, Stockholm, Sweden.
1Karolinska Institutet, Stockholm, Sweden, 2Ciencia Research, Stockholm, Sweden.
OBJECTIVES: In the past decade, targeted treatments have been introduced to routine management of patients with acute myeloid leukemia (AML). Importantly, FLT3 inhibitors (FLT3i) significantly improved outcomes for patients with FLT3-mutated AML in both the first-line and relapsed/refractory settings. These patients have historically been associated with an unfavorable prognosis. The aim was to understand the uptake of FLT3is in Sweden and to evaluate the overall survival of AML patients treated with FLT3is.
METHODS: This retrospective study included all adult patients diagnosed with AML
(ICD-10-SE: C92.0) between 1 Jan 2018 to 31 Dec 2022 in Sweden. Linked data from the National Patient Register, the National Cancer Register, the Prescribed Drug Register, and the Cause of Death Register were utilized. FLT3i exposure was determined using drug dispensation data for midostaurin and gilteritinib (reimbursed in Sweden since 2018 and 2021, respectively). Overall survival was analyzed using Cox proportional hazard regression with FLT3i exposure as a time-varying covariate.
RESULTS: A total of 2,891 patients with AML were included in this study, with a median follow-up time of 189 days. One hundred forty-nine patients received FLT3i therapy, including 113 receiving gilteritinib, 22 receiving midostaurin, and 14 receiving both. The median time from AML diagnosis to first FLT3i dispensation was 46 days for midostaurin and 115.5 days for gilteritinib. After adjusting for sex, age, and year of diagnosis, FLT3i treatment was associated with a reduced risk of death compared with the non-FLT3i-treated reference group (hazard ratio: 0.70; 95% confidence interval: 0.52-0.94; p = 0.02).
CONCLUSIONS: The results show that FLT3 inhibitor treatment was associated with significantly improved survival, corresponding to a ~30% reduction in the hazard of death. Further analyses are warranted to understand the impact of other potential confounding factors on patient survival, including FLT3 mutation status which was not available in this dataset.
METHODS: This retrospective study included all adult patients diagnosed with AML
(ICD-10-SE: C92.0) between 1 Jan 2018 to 31 Dec 2022 in Sweden. Linked data from the National Patient Register, the National Cancer Register, the Prescribed Drug Register, and the Cause of Death Register were utilized. FLT3i exposure was determined using drug dispensation data for midostaurin and gilteritinib (reimbursed in Sweden since 2018 and 2021, respectively). Overall survival was analyzed using Cox proportional hazard regression with FLT3i exposure as a time-varying covariate.
RESULTS: A total of 2,891 patients with AML were included in this study, with a median follow-up time of 189 days. One hundred forty-nine patients received FLT3i therapy, including 113 receiving gilteritinib, 22 receiving midostaurin, and 14 receiving both. The median time from AML diagnosis to first FLT3i dispensation was 46 days for midostaurin and 115.5 days for gilteritinib. After adjusting for sex, age, and year of diagnosis, FLT3i treatment was associated with a reduced risk of death compared with the non-FLT3i-treated reference group (hazard ratio: 0.70; 95% confidence interval: 0.52-0.94; p = 0.02).
CONCLUSIONS: The results show that FLT3 inhibitor treatment was associated with significantly improved survival, corresponding to a ~30% reduction in the hazard of death. Further analyses are warranted to understand the impact of other potential confounding factors on patient survival, including FLT3 mutation status which was not available in this dataset.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO162
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology