Fitting Menin Inhibitors Into the AML Landscape

Eytan M. Stein, MD, hematologic oncologist and director of the Program for Drug Development in Leukemia, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, New York, discusses the currently available treatment options for patients with acute myeloid leukemia (AML) and how Menin inhibitors fit into this space.

Besides recommending patients with AML to enroll in clinical trials, patients who are younger may also receive intensive induction chemotherapy. For patients who are older in age, popular combinations include a hypomethylating agent like azacytidine [Vidaza] plus venetoclax [Venclexta].

Now, Menin inhibitors are being developed for patients with relapsed/refractory AML whose previous treatment regimen may not have worked for them. Various clinical trials evaluating Menin inhibitors as single agents are ongoing in this space.

Transcription:

0:08 | The way we currently treat AML outside of a clinical trial is that for 1 group of patients, typically those patients who are a little bit younger, we will give those patients some intensive induction chemotherapy. Then for patients who may be a little bit older, we give them the combination of a hypomethylating agent, which is typically azacytidine, with the BCL2 inhibitor, venetoclax.

0:30 | Menin inhibitors now are being developed in the setting of patients who have relapsed and refractory acute myeloid leukemia. They've gotten that treatment regimen paradigm that I just described, and it either didn't work or it worked for a brief period of time, and then the patient ended up relapsing. These drugs are currently in clinical trials in the relapsed and refractory setting as single agents.

0:52 | However, there's a lot of effort now. When you have a drug that looks to be effective in the relapsed and refractory setting, you don't want to wait for a patient to relapse to give them that drug. You want to move it up into earlier lines of therapy. When you move it up into earlier lines of therapy, you want to combine it with the standard of care agent. Now, some of the new clinical trials that are being done are combining Menin inhibitors, and specifically the Syndax drug, with that intensive induction chemotherapy and with the combination of azacitidine and venetoclax.