FLT3-D835 in R/R AML: gilteritinib superior to salvage chemo (ADMIRAL, Perl 2019 — pre-sp...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-FLT3-D835-AML-RR |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Diseases | DIS-AML |
| Sources | SRC-ADMIRAL-PERL-2019 SRC-CIVIC SRC-ELN-AML-2022 SRC-NCCN-AML-2025 |
Actionability Facts
| Biomarker | BIO-FLT3-D835 |
|---|---|
| Variant | TKD point mutation (D835Y/V; relapsed/refractory) |
| Disease | DIS-AML |
| ESCAT tier | IA |
| Recommended combinations | gilteritinib monotherapy (2L bridge to allo-SCT), gilteritinib + venetoclax + azacitidine (off-label, trial) |
| Contraindicated monotherapy | quizartinib (inactive vs D835), sorafenib (poor activity vs D835 in clinical practice) |
| Evidence summary | FLT3-D835 in R/R AML: gilteritinib superior to salvage chemo (ADMIRAL, Perl 2019 — pre-specified subset analysis showed activity across both ITD and D835/TKD; D835 subset response rates similar to ITD overall). Gilteritinib is preferred type-I FLT3i for D835-mutant R/R disease. Quizartinib remains contraindicated (no D835 activity). |
Notes
ESCAT IA. OncoKB Level 1. Per task brief: D835 R/R is well- characterized for gilteritinib (type-I) advantage over type-II.
Used By
Actionability
BMA-FLT3-ITD-AML-RR- FLT3-ITD in relapsed/refractory AML: gilteritinib monotherapy superior to salvage chemo (...