My takeaways from our @HemeReports Menin session #leusm 

1. Despite promising results of Menin-i (in a very tough to treat group of AML, i.e KMT2A-r) primary and acquired resistance remains and issue and is not limited to MEN1 mutations.  We need to learn more. ❓

2.  Combination therapies are currently Under investigation and jn development including SAVE (rev+ven+ ASTX727; currently enrolling).  has excellent preclinical models and is showing promising clinical outcomes. Count recovery is good but Ven but duration on SAVE is 14 days and not the 28 day on label. ❎3️⃣

3.. Time limited triplet therapy (such as SAVE) with deep MRD monitoring followed by  rapid de-escalation to avoid hematologic toxicity may be the way to go.  🪄 

4. Ultra sensitive NPM1 MRD monitoring is an excellent tool that will allow for deep MRD monitoring in clinical trials and for early intervention (i.e. INTERCEPT , @break_cancer) MRD-directed therapies (Menin-i for NPM1 mutated disease). 🧬

5. The MRD-directed therapies primary endpoint is MRD. at this time these are bridge to transplant approaches but this may change with time as we learn more. 🎯

6. Differentiation syndrome is more of a challenge in the monotherapy setting and less common when Menin-i is combined with chemo. Regardless, treating physicians should be well aware of DS. 

7. One for my #hemepath folks: Response assessment based on morphology in pts with Menin-i may be challenging. You may see what looks like persistent blasts in a pt that is actually responding. Be aware 

8. Need to think about how we will modify treatment strategies once we start detecting low level emergent MEN1 mutations on therapy as assays become more readily available. 

9. More to learn about the features distinguishing the different menin-i currently available. 

SO MUCH MORE TO LEARN!!! REMARKABLE PROMISE FOR OUR Pts and what a time to be involved in the care of AML pts 🤩

Thank you @Daver_Leukemia @GhayasIssa @LeukDocJZ @EuniceWangMD for joining us and your expert insights. 

@Anand_88_Patel  @KMirza @NitinJainMD @doctorpemm
#leusm