Incorporating IDH and Menin Inhibitors as Therapies for Subsets of Patients With AML

At the 2023 Great Debates & Updates in Hematologic Malignancies Meeting in Boston, Massachusetts, Amir Fathi, MD, Massachusetts General Hospital, Boston, Massachusetts, shares insights into the incorporation of IDH and menin inhibitors as therapies for subsets of patients with acute myeloid leukemia (AML). 

Transcript:

My name is Amir Fathi. I'm a leukemia specialist at Massachusetts General Hospital. It's a pleasure to be here at the Great Debates [and Updates in Hematologic Malignancies meeting] in Boston, and specifically talk about acute myeloid leukemia. I was tasked today to speak about menin inhibition and IDH inhibition in AML, which are 2 novel ways to target subsets of AML.

The development [of] IDH inhibitors, both IDH1 and IDH2 inhibitors, have really transformed the field. Ivosidenib, the IDH1 inhibitor, [and] enasidenib, the IDH2 inhibitor, have both been approved in AML, and with IDH2 in the relapsed/refractory setting with ivosidenib in both the relapsed/refractory, as well as the upfront setting in combination. It's a really exciting couple of drugs that are available for IDH-mutated patients. There have been multiple trials that have really shown its tolerability and benefit.

As far as menin inhibition, that is a class of drug that is being developed for patients with NPM1 mutations and KMT2A rearrangements, another subset of AML that is emerging in terms of potential responsiveness to therapy. These drugs are in clinical trials and showing a lot of promise in clinical trials, and we presented some of the data that was provided at recent meetings today. I hope we'll learn more in the years to come.

These new developments, I think, add to our current armamentarium in acute myeloid leukemia. For many decades, we had only intensive chemotherapy available for younger patients and not much for older patients. 

Now we have novel targeted therapies that we can either use as single agents as monotherapies or in combinations with standard therapies, which will hopefully improve our outcomes for AML. I think the standard of care is really developing and emerging, specifically in subsets of AML that are targetable.

Source: 

Fathi, A. What Is New in Relapsed AML With a Focus on Menin and IDH Inhibitors? Presented at the Great Debates and Updates in Hematologic Malignancies Meeting; August 17-19, 2023; Boston, Massachusetts.