gilteritinib + venetoclax + azacitidine + cytarabine

This combination regimen, evaluated in the GANCE trial by the First Affiliated Hospital of Zhejiang University, is a multi-phase treatment strategy for newly diagnosed, intermediate-risk acute myeloid leukemia (AML) patients with FLT3-ITD mutations. The regimen consists of an induction phase using 'GVA' (gilteritinib, venetoclax, and azacitidine) followed by a consolidation phase using high-dose cytarabine (HiDAC) and gilteritinib, and a final maintenance phase with gilteritinib. Gilteritinib is a potent FLT3 inhibitor, venetoclax is a BCL-2 inhibitor that promotes apoptosis, azacitidine is a hypomethylating agent, and cytarabine is a pyrimidine analog that interferes with DNA synthesis. This approach aims to achieve deep molecular remission and potentially replace the need for allogeneic hematopoietic stem cell transplantation in fit patients. Note: The term 'HDAC' in the trial context refers to High-Dose Ara-C (cytarabine), rather than a histone deacetylase inhibitor.

Brand names

VenclextaVidazaCytosar-U

Other names

GVA + HiDACGVA + HDAC ConsolidationGilteritinib + VA RegimenGVA + histone deacetylase inhibitor + gilteritinib