Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.


Advances in patient care through increasingly individualized therapy

In 2018, the acute myeloid leukaemia treatment landscape expanded notably, with several trials leading to the approval of novel targeted therapies. Furthermore, comprehensive sequencing revealed the effects of co-occurring mutations and gene expression patterns on drug sensitivity, providing hope that future treatments will be increasingly precise and personalized.

Key advances

  • The addition of the multikinase inhibitor midostaurin to 7 + 3 chemotherapy for newly diagnosed patients and the use of second-generation fms-related tyrosine kinase 3 (FLT3) inhibitors (such as quizartinib) for those with relapsed and/or refractory (R/R) FLT3-mutant acute myeloid leukaemia (AML) demonstrate improved overall survival (OS) compared with standard-of-care therapy2,3,4.

  • The oral targeted mutant isocitrate dehydrogenase 1 (IDH1) inhibitor ivosidenib is now approved for the treatment of patients with R/R AML with an IDH1 mutation, as a result of the substantial activity and durable responses seen in a phase I trial5.

  • In adults with newly diagnosed secondary or therapy-related AML, the liposomal encapsulation of cytarabine plus daunorubicin at a fixed 5:1 molar ratio improved response rates and median OS compared with standard 7 + 3 therapy in a randomized phase III trial6.

  • The addition of the BCL2-inhibitor venetoclax to lower-intensity AML therapy, such as hypomethylating agents or low-dose cytarabine, for older patients unsuitable for intensive chemotherapy approaches suggests markedly improved patient outcomes; confirmatory randomized trials are ongoing7,9.

  • Clinical and genomic data from patients with AML, including whole-exome and RNA sequencing, and analysis of ex vivo sensitivity to >100 agents is now freely available and is likely to accelerate and enable future discovery10.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Get just this article for as long as you need it


Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Developments in the treatment of AML.


  1. Noone, A. M. et al. SEER cancer statistics review (CSR) 1975–2015. SEER (2018).

  2. Stone, R. M. et al. Midostaurin plus chemotherapy for acute myeloid leukemia with a FLT3 mutation. N. Engl. J. Med. 377, 454–464 (2017).

    Article  CAS  Google Scholar 

  3. Cortes, J. et al. Quizartinib, an FLT3 inhibitor, as monotherapy in patients with relapsed or refractory acute myeloid leukaemia: an open-label, multicentre, single-arm, phase 2 trial. Lancet Oncol. 19, 889–903 (2018).

    Article  CAS  Google Scholar 

  4. Cortes, J. K. S. et al. in 23rd Congress of The European Hematology Association (EHA) LB2600 (European Hematology Association, Stockholm, 2018).

  5. DiNardo, C. D. et al. Durable remissions with ivosidenib in IDH1-mutated relapsed or refractory AML. N. Engl. J. Med. 378, 2386–2398 (2018).

    Article  CAS  Google Scholar 

  6. Lancet, J. E. et al. CPX-351 (cytarabine and daunorubicin) liposome for injection versus conventional cytarabine plus daunorubicin in older patients with newly diagnosed secondary acute myeloid leukemia. J. Clin. Oncol. 36, 2684–2692 (2018).

    Article  CAS  Google Scholar 

  7. DiNardo, C. D. et al. Venetoclax combined with decitabine or azacitidine in treatment-naive, elderly patients with acute myeloid leukemia. Blood (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  8. Cortes, J. E. et al. A phase 2 randomized study of low dose Ara-C with or without glasdegib (PF-04449913) in untreated patients with acute myeloid leukemia or high-risk myelodysplastic syndrome. Blood 128, 99 (2016).

    Google Scholar 

  9. Wei, A. et al. Phase 1/2 study of venetoclax with low-dose cytarabine in treatment-naive, elderly patients with acute myeloid leukemia unfit for intensive chemotherapy: 1-year outcomes. Blood 130 (Suppl. 1), 890 (2017).

    Google Scholar 

  10. Tyner, J. W. et al. Functional genomic landscape of acute myeloid leukaemia. Nature 562, 526–531 (2018).

    Article  CAS  Google Scholar 

Download references


C.D.D. is supported by The V Foundation for Cancer Research and the MD Anderson Khalifa Clinical Scholar Award.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Courtney D. DiNardo.

Ethics declarations

Competing interests

C.D.D. is a consultant of Abbvie, Agios and Celgene and has received honoraria from Bayer, Jazz, Karyopharm, Medimmune and Syros as an advisory board member. A.E.P. is a consultant for Abbvie, Arog, Astellas and Daiichi Sankyo. Additionally, he has received honoraria from Actinium Pharmaceuticals, Agios, Jazz Pharmaceuticals, NewLink Genetics, Novartis and Takeda as an advisory board member.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

DiNardo, C.D., Perl, A.E. Advances in patient care through increasingly individualized therapy. Nat Rev Clin Oncol 16, 73–74 (2019).

Download citation

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing