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Sorafenib Maintenance After Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia With FLT3–Internal Tandem Duplication Mutation (SORMAIN)

Open access
Burchert, Andreas, Bug, Gesine, Fritz, Lea V., Finke, Jürgen, Stelljes, Matthias, Röllig, Christoph, Wollmer, Ellen, Wäsch, Ralph, Bornhäuser, Martin, Berg, Tobias, Lang, Fabian, Ehninger, Gerhard, Serve, Hubert, Zeiser, Robert, Wagner, Eva-Maria, Kröger, Nicolaus, Wolschke, Christine, Schleuning, Michael, Götze, Katharina S., Schmid, Christoph, Crysandt, Martina, Eßeling, Eva, Wolf, Dominik, Wang, Ying, Böhm, Alexandra, Thiede, Christian, Haferlach, Torsten, Michel, Christian, Bethge, Wolfgang, Wündisch, Thomas, Brandts, Christian, Harnisch, Susanne, Wittenberg, Michael, Hoeffkes, Heinz-Gert, Rospleszcz, Susanne, Burchardt, Alexander, Neubauer, Andreas, Brugger, Markus, Strauch, Konstantin, Schade-Brittinger, Carmen, Metzelder, Stephan K.·2020·Journal of Clinical Oncology

Abstract

PURPOSE: Despite undergoing allogeneic hematopoietic stem cell transplantation (HCT), patients with acute myeloid leukemia (AML) with internal tandem duplication mutation in the FMS-like tyrosine kinase 3 gene ( FLT3-ITD) have a poor prognosis, frequently relapse, and die as a result of AML. It is currently unknown whether a maintenance therapy using FLT3 inhibitors, such as the multitargeted tyrosine kinase inhibitor sorafenib, improves outcome after HCT. PATIENTS AND METHODS: In a randomized, placebo-controlled, double-blind phase II trial (SORMAIN; German Clinical Trials Register: DRKS00000591), 83 adult patients with FLT3-ITD–positive AML in complete hematologic remission after HCT were randomly assigned to receive for 24 months either the multitargeted and FLT3-kinase inhibitor sorafenib (n = 43) or placebo (n = 40 placebo). Relapse-free survival (RFS) was the primary endpoint of this trial. Relapse was defined as relapse or death, whatever occurred first. RESULTS: With a median follow-up of 41.8 months, the hazard ratio (HR) for relapse or death in the sorafenib group versus placebo group was 0.39 (95% CI, 0.18 to 0.85; log-rank P = .013). The 24-month RFS probability was 53.3% (95% CI, 0.36 to 0.68) with placebo versus 85.0% (95% CI, 0.70 to 0.93) with sorafenib (HR, 0.256; 95% CI, 0.10 to 0.65; log-rank P = .002). Exploratory data show that patients with undetectable minimal residual disease (MRD) before HCT and those with detectable MRD after HCT derive the strongest benefit from sorafenib. CONCLUSION: Sorafenib maintenance therapy reduces the risk of relapse and death after HCT for FLT3-ITD–positive AML.

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Metadata

Authors
Burchert, A., Bug, G., Fritz, L. V., Finke, J., Stelljes, M., Röllig, C., Wollmer, E., Wäsch, R., Bornhäuser, M., Berg, T., Lang, F., Ehninger, G., Serve, H., Zeiser, R., Wagner, E.-M., Kröger, N., Wolschke, C., Schleuning, M., Götze, K. S., Schmid, C., Crysandt, M., Eßeling, E., Wolf, D., Wang, Y., Böhm, A., Thiede, C., Haferlach, T., Michel, C., Bethge, W., Wündisch, T., Brandts, C., Harnisch, S., Wittenberg, M., Hoeffkes, H.-G., Rospleszcz, S., Burchardt, A., Neubauer, A., Brugger, M., Strauch, K., Schade-Brittinger, C., & Metzelder, S. K.
Venue
Journal of Clinical Oncology
Published
2020-09-10
Volume
38
Issue
26
Pages
2993-3002
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
OpenAlex
W3042846071
Cited by
555
References
44
FWCI
42.94
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Sorafenib Maintenance After Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia With FLT3–Internal Tandem Duplication Mutation (SORMAIN). https://app.cochat.ai/papers/10.1200/jco.19.03345
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Burchert, A., Bug, G., Fritz, L. V., Finke, J., Stelljes, M., Röllig, C., Wollmer, E., Wäsch, R., Bornhäuser, M., Berg, T., Lang, F., Ehninger, G., Serve, H., Zeiser, R., Wagner, E.-M., Kröger, N., Wolschke, C., Schleuning, M., Götze, K. S., . . . Metzelder, S. K. (2020). Sorafenib Maintenance After Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia With FLT3–Internal Tandem Duplication Mutation (SORMAIN). Journal of Clinical Oncology. https://doi.org/10.1200/jco.19.03345

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.