# FLT3 inhibitor + intensive chemotherapy

Source: https://onco.cc/pairings/flt3i-plus-7-3/  
OnCo record `flt3i-plus-7-3` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding a FLT3 blocker to standard chemotherapy is the proven way to improve survival in FLT3-mutated AML.

## Summary

This combination adds a FLT3 inhibitor, quizartinib or midostaurin, to intensive cytarabine and anthracycline induction chemotherapy, the 7+3 regimen, in FLT3-mutated acute myeloid leukaemia. Chemotherapy debulks the leukaemia while FLT3 inhibition removes the proliferative driver and suppresses the resistant subclone that would otherwise cause relapse. Two positive phase 3 trials with different molecules, RATIFY with midostaurin and QuANTUM-First with quizartinib, both improved overall survival, and quizartinib is continued as maintenance after induction. Maintenance with gilteritinib after transplant, tested in MORPHO, adds further protection in patients who are MRD-positive.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Quizartinib + Cytarabine + anthracycline ('7+3')
- Type: combination
- Rationale: Chemotherapy debulks; FLT3 inhibition removes the proliferative driver and suppresses the resistant subclone that would otherwise relapse.
- Evidence: Two positive phase 3 trials with different molecules.

## Sources

- ClinicalTrials.gov NCT00651261: RATIFY (CALGB 10603): https://clinicaltrials.gov/study/NCT00651261
- ClinicalTrials.gov NCT02668653: QuANTUM-First: https://clinicaltrials.gov/study/NCT02668653

## Connected records

- cancers: [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [FLT3-mutated acute myeloid leukaemia](https://onco.cc/cancers/aml-flt3/)
- targets: [FLT3](https://onco.cc/targets/flt3/)
- drugs: [Cytarabine + anthracycline ('7+3')](https://onco.cc/drugs/cytarabine-7-3/), [Gilteritinib](https://onco.cc/drugs/gilteritinib/), [Midostaurin](https://onco.cc/drugs/midostaurin/), [Quizartinib](https://onco.cc/drugs/quizartinib/)
- trials: [QuANTUM-First](https://onco.cc/trials/quantum-first/), [RATIFY (CALGB 10603)](https://onco.cc/trials/ratify/)
- key papers: [QuANTUM-First: quizartinib added to intensive chemotherapy and continued as maintenance in newly diagnosed FLT3-ITD AML](https://onco.cc/key-papers/paper-quantum-first-quizartinib-lancet-2023/)

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