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ASH 2024 | Top AML highlights from ASH 2024: menin inhibitors & gilteritinib versus midostaurin in induction
Mark Levis, MD, PhD, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, comments on the recent developments in the treatment of acute myeloid leukemia (AML), sharing his highlights from the ASH 2024 Annual Meeting. Dr Levis discusses the rapid emergence of menin inhibitors and the potential of enzomenib due to its unique mechanism of action and mentions data comparing the addition of gilteritinib or midostaurin to induction chemotherapy for newly diagnosed patients with FLT3-mutant AML. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
So everybody’s eyes are on the menin inhibitor session. They’re literally… menin inhibitors are coming so fast and so numerous that ASH has an entire session on them. And there’s seemingly more drugs than we can keep track of. We’ve already had FDA approval of revumenib as the first one across the finish line, but others are coming very fast...
So everybody’s eyes are on the menin inhibitor session. They’re literally… menin inhibitors are coming so fast and so numerous that ASH has an entire session on them. And there’s seemingly more drugs than we can keep track of. We’ve already had FDA approval of revumenib as the first one across the finish line, but others are coming very fast. Presumably ziftomenib is the next one coming, followed I suspect by bleximenib and or enzomenib. They at least have names that are easy to remember.
One abstract that we are presenting on enzomenib highlights the fact that this is a different drug. Unlike the other menin inhibitors, enzomenib doesn’t interact with azoles, meaning it does not have the CYP3A4 interaction that is a burden on so many of these drugs. So you can combine it with an azole. Probably can combine it safely with a FLT3 inhibitor without the drug interaction problems. Potentially give it after transplant and not have a problem with your tacrolimus or sirolimus or cyclosporine. So I think they’re all potentially going to be of interest. We’re glad we have them all. Enzomenib is kind of an interesting one that is, in my view, stands out a bit from the others right now.
And then finally, in the AML session going along in parallel today will be, I think, some very important data presented on a comparison of induction chemotherapy plus either gilteritinib or midostaurin for newly diagnosed patients with FLT3-mutant AML, specifically looking again at MRD. And the interesting finding was A, there was a better overall remission rate with gilteritinib, but not a deeper MRD rate, at least after the initial induction. But interestingly, looking at the triple mutation, DNMT3, NPM1, FLT3, ITD, those patients did have a dramatic improvement with gilteritinib, or seemingly improvement with gilteritinib over midostaurin. And so the theme again holds that subset is being defined as something that really needs a potent selective FLT3 inhibitor to benefit.
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Disclosures
Takeda: Consultancy; Novartis: Consultancy; Daiichi Sankyo: Consultancy; Bristol Myers Squibb: Consultancy; Astellas: Consultancy; Abbvie: Consultancy.
