130 Quick summary: These long term results establish FLAG based combination therapies as a highly effective frontline standard for adults with core binding factor acute myeloid leukaemia, achieving a notable five year survival rate of up to 80% when paired with gemtuzumab ozogamicin. By maintaining durable efficacy even in patients with traditionally high risk mutations, this regimen offers a robust clinical pathway that significantly reduces the likelihood of relapse and strengthens overall recovery prospects. These findings provide healthcare practitioners with clear evidence to refine treatment protocols towards more consistent patient outcomes, directly influencing public policy and clinical guidelines for managing this specific leukaemia subtype. A new analysis by researchers at The University of Texas MD Anderson Cancer Center demonstrates that combination therapy consisting of fludarabine, cytarabine and G-CSF (FLAG) plus gemtuzumab ozogamicin (GO) or idarubicin (IDA) continues to deliver strong long-term outcomes for patients with core-binding factor acute myeloid leukaemia (CBF-AML), a subtype of the disease involving a chromosomal rearrangement. The study, published in Blood Cancer Discovery, was co-led by Gautam Borthakur, MD, Professor of Leukaemia, and Jayastu Senapati, MD, Assistant Professor of Leukaemia. The researchers analysed long-term outcomes from a cohort of patients treated in a Phase 2 trial. The five-year overall survival rate reached 74%, while the relapse-free survival rate was 67% for patients treated in this study. Among patients who had received GO along with FLAG (FLAG–GO), the five-year overall survival rate was higher at 80% compared with FLAG–IDA in non-randomised comparisons. “This is one of the highest reported five-year, relapse-free overall survival rates we have observed,” Borthakur said. “This regimen is now our standard frontline therapy for adults with core-binding factor AML, and these findings further strengthen the evidence supporting its use.” CBF-AML is considered a favourable-risk leukaemia, but relapse remains a major challenge. The ability to demonstrate high five-year overall survival rates with FLAG-based therapy, particularly FLAG–GO, confirms that this regimen is safe and provides durable efficacy, according to the researchers. The Phase 2 clinical trial treated 219 newly diagnosed patients at UT MD Anderson. Researchers also examined whether baseline concurrent myeloid mutations influenced treatment outcomes. The study showed that these mutations – including KIT mutations, which traditionally have been considered adverse – did not affect survival outcomes or the dynamics of deep molecular responses achieved by the patients.