- de Botton, Stéphane;
- Fenaux, Pierre;
- Yee, Karen;
- Récher, Christian;
- Wei, Andrew;
- Montesinos, Pau;
- Taussig, David;
- Pigneux, Arnaud;
- Braun, Thorsten;
- Curti, Antonio;
- Grove, Carolyn;
- Khwaja, Asim;
- Legrand, Ollivier;
- Peterlin, Pierre;
- Arnan, Montserrat;
- Blum, William;
- Cilloni, Daniela;
- Hiwase, Devendra;
- Jurcic, Joseph;
- Krauter, Jürgen;
- Thomas, Xavier;
- Watts, Justin;
- Yang, Jay;
- Polyanskaya, Olga;
- Brevard, Julie;
- Sweeney, Jennifer;
- Barrett, Emma;
- Cortes, Jorge;
- Jonas, Brian
Olutasidenib (FT-2102) is a potent, selective, oral, small-molecule inhibitor of mutant isocitrate dehydrogenase 1 (mIDH1). Overall, 153 IDH1 inhibitor-naive patients with mIDH1R132 relapsed/refractory (R/R) acute myeloid leukemia (AML) received olutasidenib monotherapy 150 mg twice daily in the pivotal cohort of this study. The median age of participants was 71 years (range, 32-87 years) and the median number of prior regimens received by patients was 2 (1-7). The rate of complete remission (CR) plus CR with partial hematologic recovery (CRh) was 35%, and the overall response rate was 48%. Response rates were similar in patients who had, and who had not, received prior venetoclax. With 55% of patients censored at the time of data cut-off, the median duration of CR/CRh was 25.9 months. The median duration of overall response was 11.7 months, and the median overall survival was 11.6 months. Of 86 patients who were transfusion dependent at baseline, a 56-day transfusion independence was achieved in 29 (34%), which included patients in all response groups. Grade 3 or 4 treatment-emergent adverse events (≥10%) were febrile neutropenia and anemia (n = 31; 20% each), thrombocytopenia (n = 25; 16%), and neutropenia (n = 20; 13%). Differentiation syndrome adverse events of special interest occurred in 22 (14%) patients, with 14 (9%) grade ≥3 and 1 fatal case reported. Overall, olutasidenib induced durable remissions and transfusion independence with a well-characterized and manageable side effect profile. The observed efficacy represents a therapeutic advance in this molecularly defined, poor-prognostic population of patients with mIDH1 R/R AML. This trial was registered at www.clinicaltrials.gov as #NCT02719574.