Oral Agents Provide Greater Acute Myeloid Leukemia Treatment Diversity

Treatment for those with acute myeloid leukemia (AML) depends on a variety of factors, according to Zahra Mahmoudjafari, PharmD, MBA, BCOP, FHOPA, which include stage of treatment, transplant eligibility, and mutational status.

In an interview with CancerNetwork®, Mahmoudjafari discussed standard pharmacologic options for patients being treated for AML. She began by highlighting the emergence of oral options for these patients, who historically were limited to intravenous (IV) induction therapy. Moreover, she expressed that a greater spectrum of therapeutics enables a more tailored approach, particularly among patients with specific mutational statuses.

Specifically, Mahmoudjafari expressed that oral agents available for FLT3 and IDH1/IDH2 mutations may help overcome challenges that historically emerged with a patient’s prognosis. Additionally, she explained that hypomethylating agents may better treat patients who may be unfit or ineligible for transplantation.

Mahmoudjafari is a Clinical Pharmacy Manager in the Division of Hematologic Malignancies and Cellular Therapeutics at the University of Kansas Health System.

Transcript:

We have both oral and IV options. Now, traditionally, back when I was being trained, the only options that were available on the market were IV options, usually an induction. If a patient was generally fit, [and] had not been treated previously, then we would treat with a combination of cytarabine or daunorubicin that's typically given IV. But now, with time and a lot more experience, we have [many] additional options that allow us to tailor therapies to some specific mutations that patients may have.

For instance, FLT3 is a mutation that we know can cause some significant challenges to a patient’s overall prognosis. We now have oral agents that are available that treat FLT3 [mutations]. We also have IDH1 and IDH2 oral treatment options that are available as well. For patients who are a bit more elderly, who may be transplant ineligible, we have now seen more hypomethylating agents.

The treatment of AML depends on whether they are in induction, at the beginning of their treatment journey, in consolidation, and/or if they are going to transplant. The treatment regimens do vary, but we have, thankfully, both oral and IV options now.