So when we think about secondary AML, it’s really kind of a group of diseases. AML that’s coming from prior chemotherapy or radiation therapy. AML that’s coming from people who have had either MDS or MPN, which can either be treated or not treated. And then patients who have a secondary phenotype or the secondary AML molecular signature. And when we look at the FDA-approved therapy for secondary AML, CPX-351, the entry criteria for that randomized trial was just the bucket secondary AML, prior MDS, AML MRC...
So when we think about secondary AML, it’s really kind of a group of diseases. AML that’s coming from prior chemotherapy or radiation therapy. AML that’s coming from people who have had either MDS or MPN, which can either be treated or not treated. And then patients who have a secondary phenotype or the secondary AML molecular signature. And when we look at the FDA-approved therapy for secondary AML, CPX-351, the entry criteria for that randomized trial was just the bucket secondary AML, prior MDS, AML MRC. We didn’t have data on those genetic mutations that would have put people into the trial. And so when we think about it, we’re looking for differences, say, in treatment-related AML and how those patients might do or what might be better. We’re really looking at subset analysis from the landmark 301 study of CPX-351 versus 7 and 3, or we’re looking at real-world data sets. And as we continue to take this secondary AML group and slice the pie smaller and smaller, it becomes a little more difficult to interpret the data just because the numbers are so small. There’s certainly data from the AML-19 trial conducted in the UK suggesting that patients with that secondary AML molecular signature have not better response rates, but better overall survival than patients who got flag-ida. And so that can help guide your treatment. There’s also been some more recent data sets that don’t show a difference in terms of, these are all retrospective, but in terms of how those patients do going forward, particularly the patients with the molecular signature. And so it’ll certainly be important as future clinical trials are done to develop a more robust data set of that molecular information so then we can do these analyses later on.
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