Network Meta-Analysis Compares FLT3 Inhibitors in Acute Myeloid Leukemia

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Frontiers in Medicine Published May 11, 2026 Medically reviewed May 11, 2026 DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Consider gilteritinib and midostaurin for remission, and gilteritinib or quizartinib for survival in AML, but weigh increased adverse event risks.

This network meta-analysis evaluated the efficacy of FLT3 inhibitors (gilteritinib, midostaurin, quizartinib) in acute myeloid leukemia patients, pooling data from 6128 individuals. The analysis focused on complete remission rate and overall survival as key outcomes.

For complete remission, gilteritinib (OR 1.75, 95% CI 1.16–2.66) and midostaurin (OR 1.31, 95% CI 1.07–1.60) showed significant improvements compared to control. For overall survival, gilteritinib (HR 0.70, 95% CI 0.49–0.99) and quizartinib (HR 0.73, 95% CI 0.54–0.98) significantly prolonged survival.

Safety analysis indicated significantly higher risks of adverse events in the experimental group, including reduced neutrophil count, anemia, elevated liver enzymes, fatigue, thrombocytopenia, dyspnea, and neutropenia. Serious adverse events and discontinuation rates were not reported.

The authors did not specify limitations, but the meta-analysis is based on RCTs, so findings represent associations. The control group and follow-up duration were not detailed, limiting direct clinical application. This evidence supports treatment strategy selection but requires integration with individual patient factors and safety profiles.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

BackgroundAlong with the more and more clinical application of various FLT3 inhibitors in acute myeloid leukemia (AML), their real clinical benefits still remain a debated topic. Therefore, this study uses a network meta-analysis method to make comparison on the treatment efficacy and safety situation of different FLT3 inhibitors, hence aiming to offer evidence-based supporting materials for the selection work of clinical treatment strategies.MethodsA systemic search action was carried out inside PubMed, Web of Science, Cochrane Library, and Embase, from the starting time of each database until December 17, 2025, for the aim to find randomized controlled trials of FLT3 inhibitors used for AML treatment. Stata 18.0 and R Studio software were applied to conduct network meta-analysis, hence RevMan 5.4 software was utilized to perform literature quality appraisal and bias risk assessment.ResultsTwenty RCTs with total 6128 acute myeloid leukemia patients are contained. Efficacy comparison outcomes have demonstrated that treatment with FLT3 inhibitors Gilteritinib (OR = 1.75, 95% CI: 1.16–2.66) and Midostaurin (OR = 1.31, 95% CI: 1.07–1.60) can produce significant improvement in patients’ complete remission rate. Therefore, survival analysis has found that Gilteritinib (HR = 0.70, 95% CI: 0.49–0.99) and Quizartinib (HR = 0.73, 95% CI: 0.54–0.98) can significantly prolong patients’ overall survival (OS). Thus, safety evaluation results have shown that, compared with the control group, the experimental group bears significantly higher risk of adverse events including reduced neutrophil count, anemia, elevated alanine aminotransferase, elevated aspartate aminotransferase, fatigue, thrombocytopenia, dyspnea, and neutropenia (P