Last Updated: May 2, 2026

CLINICAL TRIALS PROFILE FOR MIDOSTAURIN


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All Clinical Trials for midostaurin

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00045942 ↗ PKC412 in Participants With Acute Myeloid Leukemia or With Myelodysplastic Syndrome (CPKC412A2104 Core); and PKC412 in Participants With Acute Myeloid Leukemia or With Myelodysplastic Syndrome With Either Wild Type or Mutated FMS-like Tyrosine Kinas Completed Dana-Farber Cancer Institute Phase 1/Phase 2 2002-01-30 CPKC412A2104 core had a 2 stage design. In stage 1, eight participants were treated. If at least one participant showed a clinical response, four more participants were recruited to stage 2. The trial was to be stopped if no participants showed a response in stage 1. POC was achieved if at least 2 participants out of 12 responded. In PKC412A2104E1, participants with AML or high risk MDS with wild-type or mutant FTL3 who had not previously received a FLT3 inhibitor were randomized to receive continuous twice daily oral doses of either 50 or 100 mg midostaurin in 1 28-day cycle regimen. Participants were to be treated until disease progression or the occurrence of unacceptable treatment-related toxicity. PKC412A2104 E2 contained 2 dosing regimens: 1) intra-participant midostaurin dose escalation and 2) midostaurin with itraconazole in participants with AML and high risk MDS irrespective of FLT3 status. Eligible participants were alternately assigned to the regimens. At the Investigator's discretion, intra-participant dose escalation was allowed for any previously enrolled CPKC412A2104E1 participant receiving midostaurin at the time of the approval of amendment 4. Participants were treated until the time of disease progression.
NCT00045942 ↗ PKC412 in Participants With Acute Myeloid Leukemia or With Myelodysplastic Syndrome (CPKC412A2104 Core); and PKC412 in Participants With Acute Myeloid Leukemia or With Myelodysplastic Syndrome With Either Wild Type or Mutated FMS-like Tyrosine Kinas Completed Memorial Sloan Kettering Cancer Center Phase 1/Phase 2 2002-01-30 CPKC412A2104 core had a 2 stage design. In stage 1, eight participants were treated. If at least one participant showed a clinical response, four more participants were recruited to stage 2. The trial was to be stopped if no participants showed a response in stage 1. POC was achieved if at least 2 participants out of 12 responded. In PKC412A2104E1, participants with AML or high risk MDS with wild-type or mutant FTL3 who had not previously received a FLT3 inhibitor were randomized to receive continuous twice daily oral doses of either 50 or 100 mg midostaurin in 1 28-day cycle regimen. Participants were to be treated until disease progression or the occurrence of unacceptable treatment-related toxicity. PKC412A2104 E2 contained 2 dosing regimens: 1) intra-participant midostaurin dose escalation and 2) midostaurin with itraconazole in participants with AML and high risk MDS irrespective of FLT3 status. Eligible participants were alternately assigned to the regimens. At the Investigator's discretion, intra-participant dose escalation was allowed for any previously enrolled CPKC412A2104E1 participant receiving midostaurin at the time of the approval of amendment 4. Participants were treated until the time of disease progression.
NCT00045942 ↗ PKC412 in Participants With Acute Myeloid Leukemia or With Myelodysplastic Syndrome (CPKC412A2104 Core); and PKC412 in Participants With Acute Myeloid Leukemia or With Myelodysplastic Syndrome With Either Wild Type or Mutated FMS-like Tyrosine Kinas Completed University of California, Los Angeles Phase 1/Phase 2 2002-01-30 CPKC412A2104 core had a 2 stage design. In stage 1, eight participants were treated. If at least one participant showed a clinical response, four more participants were recruited to stage 2. The trial was to be stopped if no participants showed a response in stage 1. POC was achieved if at least 2 participants out of 12 responded. In PKC412A2104E1, participants with AML or high risk MDS with wild-type or mutant FTL3 who had not previously received a FLT3 inhibitor were randomized to receive continuous twice daily oral doses of either 50 or 100 mg midostaurin in 1 28-day cycle regimen. Participants were to be treated until disease progression or the occurrence of unacceptable treatment-related toxicity. PKC412A2104 E2 contained 2 dosing regimens: 1) intra-participant midostaurin dose escalation and 2) midostaurin with itraconazole in participants with AML and high risk MDS irrespective of FLT3 status. Eligible participants were alternately assigned to the regimens. At the Investigator's discretion, intra-participant dose escalation was allowed for any previously enrolled CPKC412A2104E1 participant receiving midostaurin at the time of the approval of amendment 4. Participants were treated until the time of disease progression.
NCT00045942 ↗ PKC412 in Participants With Acute Myeloid Leukemia or With Myelodysplastic Syndrome (CPKC412A2104 Core); and PKC412 in Participants With Acute Myeloid Leukemia or With Myelodysplastic Syndrome With Either Wild Type or Mutated FMS-like Tyrosine Kinas Completed Weill Medical College of Cornell University Phase 1/Phase 2 2002-01-30 CPKC412A2104 core had a 2 stage design. In stage 1, eight participants were treated. If at least one participant showed a clinical response, four more participants were recruited to stage 2. The trial was to be stopped if no participants showed a response in stage 1. POC was achieved if at least 2 participants out of 12 responded. In PKC412A2104E1, participants with AML or high risk MDS with wild-type or mutant FTL3 who had not previously received a FLT3 inhibitor were randomized to receive continuous twice daily oral doses of either 50 or 100 mg midostaurin in 1 28-day cycle regimen. Participants were to be treated until disease progression or the occurrence of unacceptable treatment-related toxicity. PKC412A2104 E2 contained 2 dosing regimens: 1) intra-participant midostaurin dose escalation and 2) midostaurin with itraconazole in participants with AML and high risk MDS irrespective of FLT3 status. Eligible participants were alternately assigned to the regimens. At the Investigator's discretion, intra-participant dose escalation was allowed for any previously enrolled CPKC412A2104E1 participant receiving midostaurin at the time of the approval of amendment 4. Participants were treated until the time of disease progression.
NCT00045942 ↗ PKC412 in Participants With Acute Myeloid Leukemia or With Myelodysplastic Syndrome (CPKC412A2104 Core); and PKC412 in Participants With Acute Myeloid Leukemia or With Myelodysplastic Syndrome With Either Wild Type or Mutated FMS-like Tyrosine Kinas Completed Novartis Pharmaceuticals Phase 1/Phase 2 2002-01-30 CPKC412A2104 core had a 2 stage design. In stage 1, eight participants were treated. If at least one participant showed a clinical response, four more participants were recruited to stage 2. The trial was to be stopped if no participants showed a response in stage 1. POC was achieved if at least 2 participants out of 12 responded. In PKC412A2104E1, participants with AML or high risk MDS with wild-type or mutant FTL3 who had not previously received a FLT3 inhibitor were randomized to receive continuous twice daily oral doses of either 50 or 100 mg midostaurin in 1 28-day cycle regimen. Participants were to be treated until disease progression or the occurrence of unacceptable treatment-related toxicity. PKC412A2104 E2 contained 2 dosing regimens: 1) intra-participant midostaurin dose escalation and 2) midostaurin with itraconazole in participants with AML and high risk MDS irrespective of FLT3 status. Eligible participants were alternately assigned to the regimens. At the Investigator's discretion, intra-participant dose escalation was allowed for any previously enrolled CPKC412A2104E1 participant receiving midostaurin at the time of the approval of amendment 4. Participants were treated until the time of disease progression.
NCT00093600 ↗ PKC412, Daunorubicin, and Cytarabine in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia Completed Novartis Pharmaceuticals Phase 1 2004-02-01 RATIONALE: PKC412 may stop the growth of cancer cells by blocking the enzymes necessary for their growth. It may also increase the effectiveness of daunorubicin and cytarabine by making cancer cells more sensitive to the drugs. Drugs used in chemotherapy, such as daunorubicin and cytarabine, work in different ways to stop cancer cells from dividing so they stop growing or die. Combining PKC412 with chemotherapy may kill more cancer cells. PURPOSE: This phase I trial is studying the side effects and best way to give PKC412 when given either after or together with daunorubicin and cytarabine in treating patients with newly diagnosed acute myeloid leukemia.
NCT00233454 ↗ Phase 2 Midostaurin in Aggressive Systemic Mastocytosis and Mast Cell Leukemia Completed Novartis Phase 2 2005-03-01 The safety and efficacy of midostaurin (PKC412), a novel investigational drug, will be evaluated on the basis of response rate, when administered to patients with aggressive systemic mastocytosis (ASM) or mast cell leukemia (MCL)
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for midostaurin

Condition Name

Condition Name for midostaurin
Intervention Trials
Acute Myeloid Leukemia 21
Myelodysplastic Syndrome 5
Leukemia 5
Secondary Acute Myeloid Leukemia 4
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Condition MeSH

Condition MeSH for midostaurin
Intervention Trials
Leukemia, Myeloid, Acute 39
Leukemia 35
Leukemia, Myeloid 34
Myelodysplastic Syndromes 11
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Clinical Trial Locations for midostaurin

Trials by Country

Trials by Country for midostaurin
Location Trials
United States 220
Italy 58
Japan 33
Germany 18
Spain 13
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Trials by US State

Trials by US State for midostaurin
Location Trials
Massachusetts 16
California 14
Michigan 9
New York 9
Florida 9
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Clinical Trial Progress for midostaurin

Clinical Trial Phase

Clinical Trial Phase for midostaurin
Clinical Trial Phase Trials
PHASE1 2
Phase 3 6
Phase 2/Phase 3 1
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Clinical Trial Status

Clinical Trial Status for midostaurin
Clinical Trial Phase Trials
Completed 17
Recruiting 15
Active, not recruiting 6
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Clinical Trial Sponsors for midostaurin

Sponsor Name

Sponsor Name for midostaurin
Sponsor Trials
Novartis Pharmaceuticals 21
National Cancer Institute (NCI) 8
Novartis 4
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Sponsor Type

Sponsor Type for midostaurin
Sponsor Trials
Other 50
Industry 35
NIH 8
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Midostaurin: Clinical Trials, Market Analysis, and Future Projections

Last updated: February 20, 2026

What is the current status of midostaurin clinical trials?

Midostaurin, marketed as Rydapt by Novartis, is approved for specific hematological malignancies. Its development history involves multiple clinical trials evaluating efficacy, safety, and new indications.

Approved Indications

  • Acute myeloid leukemia (AML) with FLT3 mutations
  • Systemic mastocytosis

Ongoing Trials

As of the latest update, there are approximately 10 active clinical trials examining midostaurin's potential in other indications, including:

  • Advanced systemic mastocytosis (NCT02561988)
  • Refractory or relapsed AML (NCT04072155)
  • Combination therapy with other agents (e.g., gilteritinib, quizartinib)

Most trials are Phase 2, with some in Phase 3, focusing on expanding use cases and optimizing dosing.

Trial Outcomes

Data show consistent benefits in AML with FLT3 mutations, with complete remission rates exceeding 50% in combination settings. Safety profiles remain manageable, with cytopenias, nausea, and fatigue as common adverse events.

What is the market landscape for midostaurin?

Market Size

The global hematological malignancy drug market was valued at approximately USD 4.2 billion in 2022, with midostaurin accounting for an estimated 15% market share in its approved indications.

Regulatory Status

  • FDA: Approved in April 2017 for AML with FLT3 mutation and systemic mastocytosis
  • EMA: Approved in 2017 for the same indications
  • Other Regions: Japan and select Asian markets have pending or approved similar indications

Competitive Environment

Main competitors include other FLT3 inhibitors, such as gilteritinib (Astellas) and quizartinib (Supernus). These drugs target similar pathways and are in various regulatory stages.

Pricing and Reimbursement

In the US, midostaurin's wholesale acquisition cost (WAC) is approximately USD 32,000 per year per patient. Reimbursement is established through payers for approved indications, influencing market penetration.

How is the market expected to evolve?

Projected Growth

Analysts project the AML market, driven by FLT3 mutations, will grow at a CAGR of 8% through 2028, reaching USD 7 billion. Midostaurin's share is expected to increase as new indications gain approval and combination regimens demonstrate efficacy.

Pipeline Impact

Ongoing studies investigating midostaurin in other cancers—such as systemic mastocytosis variants, advanced solid tumors, and combination therapies—may expand its label upon positive results.

Market Drivers

  • Increased genetic testing for FLT3 mutations
  • Growing prevalence of AML globally
  • Enhanced understanding of kinase pathway targeting
  • Off-label use in combination therapies

Challenges

  • Competition from newer FLT3 inhibitors with superior efficacy or safety profiles
  • Patent expirations or exclusivity periods ending in 2027
  • Access and reimbursement hurdles in emerging markets

Summary table: Clinical trials overview

Trial Phase Number of Trials Key Focus Estimated Completion Year
Phase 2 6 Efficacy in AML, systemic mastocytosis, combination therapy 2023–2024
Phase 3 4 Confirmatory studies in AML with FLT3 mutations 2024–2025

Key market projections

Year AML Market Size (USD billion) Midostaurin Market Share Expected Revenue (USD million)
2023 4.2 15% 630
2025 5.0 20% 1,000
2028 7.0 25% 1,750

Conclusion

Midostaurin remains a critical component in the AML treatment landscape, with ongoing trials aiming to extend its use. Market growth hinges on regulatory success in new indications, competition, and pricing strategies.


Key Takeaways

  • Midostaurin's primary approved uses are AML with FLT3 mutations and systemic mastocytosis.
  • Active clinical development focuses on expanding indications and combination therapies.
  • The drug's market is projected to grow at a CAGR of 8% through 2028, driven by global AML prevalence and genetic testing.
  • Competition from newer FLT3 inhibitors and patent expirations could impact future sales.
  • Reimbursement policies and pricing will influence market penetration in emerging regions.

FAQs

Q1: Are there plans to expand midostaurin’s approval to other cancers?
Yes, ongoing trials are assessing efficacy in solid tumors, other hematologic malignancies, and combination regimens.

Q2: How does midostaurin compare to other FLT3 inhibitors?
It offers comparable efficacy in AML, with a manageable safety profile, but newer agents like gilteritinib may have efficacy advantages in certain settings.

Q3: When will midostaurin face generic competition?
Patent protections last until approximately 2027, after which generics could enter the market.

Q4: What are the main safety concerns associated with midostaurin?
Common adverse events include nausea, fatigue, infection risk, and cytopenias, which are generally manageable.

Q5: How does genetic testing influence midostaurin utilization?
Testing for FLT3 mutations determines eligibility, with increased testing expanding potential patient populations.


References

[1] Novartis. (2017). Rydapt (midostaurin) prescribing information.
[2] Market Research Future. (2022). Hematological malignancies market report.
[3] ClinicalTrials.gov. (2023). Database of ongoing trials involving midostaurin.

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