Table 5 Roadmap of AML treatments
ND AML | IC candidate | FLT3 mutation | 7 + 3 + midostaurin Clinical trial: 7 + 3 + midostaurin vs 7 + 3 + gilteritinib |
Low, Intermediate risk (CD33 +) | 7 + 3 + GO | ||
Secondary AML | CPX351 | ||
IDH1/2 mutation | 7 + 3 or clinical trial | ||
No targetable Mutation | Clinical trial or 7 + 3 like regimens | ||
TP53 mutation | Clinical trial or HMA-based regimens | ||
Not IC candidate | IDH1/IDH2 mutation | Clinical trial HMA + venetoclax LDAC + venetoclax AZA + IDH inhibitor | |
FLT3 mutation | Clinical trial HMA + venetoclax LDAC + venetoclax HMA + gilteritinib | ||
No mutation | Clinical trial HMA + venetoclax LDAC + venetoclax | ||
TP53 mutation | Clinical trails AZA + magrolimab AZA + APR-246 Off trial: HMA + venetoclax LDAC + venetoclax 5 day or 10 day Decitabine | ||
R/R AML | IC candidate | Re-induction best on the clinical trial | |
CD33 +  | Clinical trials or GO based regimens, | ||
IDH1/2 mutation | Ivosidenib/enasidenib alone or HMA combination Venetoclax-based combinations (2 drugs or 3 drugs) | ||
FLT3 mutation | Gilteritinib alone or combinations with HMA Venetoclax-based combination, (2 drugs or 3 drugs) | ||
NPM1 mutation or MLL rearrangement | Clinical trials with NPM1/MLL inhibitors Venetoclax-based combination, (2 drugs or 3 drugs) | ||
TP53 mutation | Clinical trials | ||
No mutation | Clinical trials Novel first in class agents HMA-base combinations Immunotherapy: MoAbs ADC BiTE/DART Cellular therapies, CAR T, NK cells… | ||