# QuANTUM-First

Source: https://onco.cc/trials/quantum-first/  
OnCo record `quantum-first` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Roughly doubled median survival in the most aggressive FLT3 subtype by adding a selective FLT3 blocker to chemotherapy, including in patients over 60.

## Summary

Median OS 31.9 vs 15.1 months (HR 0.776, 95% CI 0.615-0.979, p=0.032) at 39.2 months median follow-up; CR rates similar but relapse-free survival and MRD-negative remissions improved; benefit maintained when censored at transplant. Lancet 2023. Basis for the July 2023 US approval. Its inclusion of patients up to 75 extended the RATIFY concept to older adults.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-07
- Registry id: NCT02668653
- Phase: 3
- Setting: Newly diagnosed FLT3-ITD AML, age 18-75: quizartinib vs placebo with 7+3, consolidation, and up to 3 years of maintenance
- Sponsor: Daiichi Sankyo
- Enrolled: 539
- Result: OS 31.9 vs 15.1 months; HR 0.776.
- Outcomes: Overall survival (median): Quizartinib + 7+3 31.9 months vs Placebo + 7+3 15.1 months, HR 0.776
- Replication: Consistent with RATIFY (midostaurin); the FLT3-inhibitor-plus-7+3 effect has now been shown with two different molecules.

## Sources

- ClinicalTrials.gov NCT02668653: https://clinicaltrials.gov/study/NCT02668653
- Lancet 2023: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00464-6/fulltext

## Connected records

- cancers: [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [FLT3-mutated acute myeloid leukaemia](https://onco.cc/cancers/aml-flt3/)
- technologies: [Small-molecule kinase inhibitors](https://onco.cc/technologies/kinase-inhibitors/)
- targets: [FLT3](https://onco.cc/targets/flt3/)
- drugs: [Cytarabine + anthracycline ('7+3')](https://onco.cc/drugs/cytarabine-7-3/), [Quizartinib](https://onco.cc/drugs/quizartinib/)
- companies: [Daiichi Sankyo](https://onco.cc/companies/daiichi-sankyo/)
- people: [Richard M. Stone](https://onco.cc/people/richard-stone/)
- pairings: [FLT3 inhibitor + intensive chemotherapy](https://onco.cc/pairings/flt3i-plus-7-3/)
- 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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