An update on menin inhibition in AML from iwAL 2024: current data, mechanisms of resistance, & more!
Oct 23, 2024
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Join experts Joshua Zeidner, MD from UNC Lineberger and Eunice Wang, MD from Roswell Park as they dive into the latest breakthroughs in menin inhibitors for acute myeloid leukemia (AML). They unravel how these inhibitors work against specific genetic mutations, offering hope in treating AML. The conversation covers exciting new data presented at the iwAL 2024, challenges in developing resistance, and the innovative combinations being explored to enhance efficacy. Get ready to learn about the future of targeted treatments in AML!
Menin inhibitors offer a promising targeted therapy for AML, especially in patients with KMT2A-rearranged and NPM1-mutated genetic profiles.
The emergence of resistance to menin inhibitors highlights the need for innovative strategies and combination therapies to improve treatment outcomes.
Deep dives
Promise of Menin Inhibitors in AML Treatment
Menin inhibitors represent a promising new class of targeted therapies for acute myeloid leukemia (AML), particularly in patients with specific genetic mutations such as NPM1 and KMT2A rearrangements. Discussion highlighted the current exploration of four menin inhibitors, including Revumenin and Ziftomenin, which are being tested in patients with relapse refractory leukemia. The data presented indicated an encouraging clinical efficacy, with Revumenin showing a complete response rate of approximately 18% in heavily pretreated adults. These therapies are moving towards potential FDA approval as early as December this year, reflecting significant progress in the development of targeted treatments for AML.
Combining Menin Inhibitors with Frontline Therapies
Research is now expanding to explore the use of menin inhibitors in combination with other frontline therapies, such as azacitidine and venetoclax, in newly diagnosed patients unfit for intensive chemotherapy. Initial data from a study indicated impressive outcomes, with a 100% response rate observed in participants, underscoring the potential of Revumenin to enhance treatment effectiveness. The rapid response to therapy, often seen after just one cycle, differs markedly from conventional approaches that may require multiple cycles for similar results. Given the early success, there is optimism about progressing to more extensive studies to solidify the role of menin inhibitors in frontline AML treatment.
Challenges of Resistance and Future Directions
While the results from menin inhibitors are promising, the emergence of resistance poses a significant challenge in the treatment landscape. Studies have reported that up to 39% of patients receiving certain menin inhibitors developed menin-resistant mutations, complicating ongoing treatment strategies. The need for understanding and overcoming these resistance mechanisms is crucial to improving patient outcomes and ensuring sustained efficacy. Ongoing research is focused on combining menin inhibitors with other therapeutic agents, such as FLT3 inhibitors, to enhance effectiveness and address the unmet needs of patients with KMT2A rearrangements, who traditionally fare poorly with standard therapies.
Menin inhibitors are emerging as a promising therapeutic approach in acute myeloid leukemia (AML), particularly in patients with specific genetic mutations such as KMT2A-rearranged and NPM1-mutated AML. These inhibitors disrupt the leukemogenic signaling pathways that drive leukemia cell proliferation by blocking the actions of menin. They can help restore regular gene expression and halt the progression of AML.
In this podcast episode, you will hear updates on menin inhibitors in AML from the 6th International Workshop on Acute Leukemias (iwAL), which took place in Phoenix, AZ. Experts Joshua Zeidner, MD, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, and Eunice Wang, MD, Roswell Park Comprehensive Cancer Center, Buffalo, NY, delve into current data on the four menin inhibitors being investigated in AML. They then go on to discuss the development of resistance to this drug class and the potential value of these agents in the post-transplant setting