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of older patients experienced cardiac
toxicities, which was “significantly more
frequent as compared with previously re-
ported cardiac event rates [which ranged
from 3 to 7 percent] ... highlighting the
necessity of close ECG and electrolyte
monitoring in this patient population.”
Older patients also experienced a
higher frequency of pulmonary adverse
events than younger patients (14% vs. 7%;
p=0.07).
treatment improved EFS in both age
subgroups (hazard ratio [HR] = 0.58; 95%
CI 0.48-0.70; p<0.001). The risk reduction
appeared to be greater for older patients
(HR=0.61; 95% CI 0.49-0.67; p<0.001)
than for younger patients (HR=0.42; 95%
CI 0.29-0.61; p<0.001).
“Maintenance with midostaurin can
be administered to only a fraction of
patients after completion of intensive
chemotherapy consolidation or alloHCT,”
“Maintenance with midostaurin can
be administered to only a fraction
of patients after completion of
intensive chemotherapy
consolidation or alloHCT.”
—RICHARD F. SCHLENK, MD
After a median follow-up of 28.9
months (range = 25-33.6):
• median EFS: 13.2 months (range =
10.0-18.3)
• median overall survival (OS): 26.0
months (range = 18.9-37.0)
Two-year EFS and OS rates were 37.7
percent and 50.9 percent, respectively.
“There was no difference in EFS ac-
cording to age group (p=0.51), but a trend
toward better OS in younger patients was
observed in the multivariable analysis
(p=0.07),” the authors reported.
According to an analysis comparing
the present study with historical controls
of five previous AML trials, midostaurin
the researchers concluded. “Therefore,
its role needs to be further explored
preferably in a randomized setting with
better-tolerated schedules and doses of
midostaurin as well as better tolerable
second-generation FLT3 inhibitors.”
Limitations of the study include its ob-
servational nature, potential confounders
that were unmeasured and unadjusted in
the multivariable analysis, and its lack of a
randomized design and placebo or active
comparator group.
The authors report relationships with
Novartis, the manufacturer of midostaurin,
which supported the trial. ●
REFERENCE
Schlenk RF, Weber D, Fiedler W, et al. Midostaurin added to chemotherapy
and continued single agent maintenance therapy in acute myeloid
leukemia with FLT3-ITD. Blood. 2018 December 18. [Epub ahead of print]
WORK AND PLAY ON MAUI, HAWAII
Pacific Permanente Group is seeking a BC/BE Hematologist/Oncologist for its
Oncology Department at Maui Memorial Medical Center in Wailuku, Maui, Hawaii.
ASH members can help patients find their
hematology practice by signing up to be
included in ASH’s Find a Hematologist
directory.
Visit www.hematology.org/Patients/FAH.aspx
to add your information!
POSITION HIGHLIGHTS:
• Join a 1 MD and 1 APRN Oncology practice.
• Broad spectrum practice with approximately 75% Medical Oncology
and 25% Hematology.
• Shared call.
• Infusion center at Maui Memorial Medical Center.
• Collaboration with Radiation Oncology Group.
• Opportunity to help build Cancer Center of Excellence on Maui.
POSITION QUALIFICATIONS:
• Board certified in Hematology and Medical Oncology.
• 5+ years of experience preferred.
Please email CV and cover letter to: [email protected]
Learn more at careers.pacificpermanente.com
24
ASH Clinical News
March 2019