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# FLT3 inhibitors

Oral kinase inhibitors for acute myeloid leukaemia with FLT3 mutations: added to first-line chemotherapy or used alone at relapse.

Updated Nov 12, 2026

## What they are

FLT3 carries activating mutations in many cases of AML, as internal tandem duplications (ITD) or point mutations. Midostaurin is added to induction chemotherapy in newly diagnosed disease; gilteritinib is used alone at relapse; quizartinib is another FLT3 inhibitor.

## Mechanism of action

FLT3 is a receptor tyrosine kinase on blood progenitors. Activating mutations keep it switched on, driving blast growth and survival. FLT3 inhibitors bind the ATP pocket and cut off this signal; blasts stop growing and some differentiate.

Target: FLT3 receptor tyrosine kinase

## Key points

- FLT3 mutation testing is done at AML diagnosis and at relapse.
- Midostaurin goes with first-line chemotherapy; gilteritinib is used alone in relapsed or refractory disease.
- Differentiation syndrome is the boxed warning of gilteritinib.
- QT prolongation and electrolyte checks apply to the class.

## Drugs in this class

- [**Midostaurin** An oral multikinase inhibitor of FLT3 and KIT, added to chemotherapy in FLT3-mutated AML and used in advanced systemic… FLT3 receptor tyrosine kinase (also KIT and other kinases)](https://durgical.com/en/pharmacology/midostaurin/)
- [**Gilteritinib** An oral FLT3 inhibitor for relapsed or refractory FLT3-mutated AML. Watch for differentiation syndrome, QT… FLT3 receptor tyrosine kinase (also other receptor tyrosine kinases)](https://durgical.com/en/pharmacology/gilteritinib/)

## Others in the class

- Quizartinib

## Test yourself

Think of the answer, then tap the question to see it.

## What are the two main types of FLT3 mutation in AML?

Internal tandem duplications (ITD) and point mutations.

## Which FLT3 inhibitor is added to induction chemotherapy?

Midostaurin.

## Which FLT3 inhibitor carries a differentiation syndrome warning and is used at relapse?

Gilteritinib.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01EX) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [Midostaurin: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a617033.html) (MedlinePlus (U.S. National Library of Medicine), 2017); [Gilteritinib: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a619003.html) (MedlinePlus (U.S. National Library of Medicine), 2019); [RCSB PDB - 6JQR: Crystal structure of FLT3 in complex with gilteritinib](https://www.rcsb.org/structure/6JQR) (RCSB Protein Data Bank, 2026).

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Source: https://durgical.com/en/pharmacology/classes/flt3-inhibitors/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/classes/flt3-inhibitors/