Menin Inhibitors Are One Among Other Improvements for Blood Cancers

Studies about menin inhibitors for patients with acute myeloid leukemia (AML) reflected many of this year’s advancements in the blood cancer space, which were presented at the 2023 American Society of Hematology (ASH) Annual Meeting.

“History will tell you that AML is a heterogeneous disease, you're going to have to attack it from multiple angles, (and menin inhibitors are) going to give us another angle to attack AML (from),” Lee Greenberger, chief scientific officer of the Leukemia and Lymphoma Society (LLS), said during an interview at ASH.

According to a study published in The Hematologist, menin inhibitors are drugs that are most effective for acute leukemias that have KMT2Ar and NPM1 mutations, most notably in AML.

Greenberger explained the benefits of menin inhibitors for patients with AML, interesting trials from this year and key takeaways for community oncologists.

Q: What are some of the studies presented at this year’s ASH meeting that have particularly caught your attention?

A: There are many of the studies that look quite promising. There are new studies in AML. And of course, you know, LLS has been involved in beating AML long-term. But this year, we've seen approvals of (Xalkori [crizotinib]). We've seen another IDH inhibitor get approved.

What’s particularly exciting is the menin inhibitor story. That story actually began at LLS, with Jolanta Grembecka, who actually we funded over 15 years ago, made the first menin inhibitor and actually developed it. And that went from our grant program to our venture philanthropy program to Kura and Syndax now has another, a similar molecule, looking for menin inhibitors and those data look quite encouraging. The important thing is it will be a brand-new molecular mechanism of action for AML. And history will tell you that AML is a heterogeneous disease, you're going to have to attack it from multiple angles, this is going to give us another angle to attack AML (from).

Q: Are there any other trials that have been interesting lately?

A: Data looking at transfusion dependencies — that’s the phase 3 trial — that looks interesting. Of course, we're going to hear about the (Darzalex [daratumumab]) quadruple therapy, compared to the triplet therapy, giving a better response rate.

(Darazalex) has already been approved, and so now, combining it upfront with the conventional agents, improved progression-free survival (length of time during and after treatment when a patient’s disease does not worsen). So that's been encouraging.

Q: What are some key takeaways from the meeting, specifically for community oncologists?

A: I think that we are aware of many patients in the community that are in need of therapies or should be getting at least consults with expert advice. First of all, by definition, all blood cancers are rare, under 200,000 patients a year. Some of these blood cancers are exceptionally rare, there could be even 1,000 cases a year. And so, the community oncologist who may be a hematology-oncology person in general, is going to see these patients very rarely, and might treat them with what is considered standard of care, but they know the standard of care for some of these disease is really (that) these patients should be on (clinical) trials, even if it's a frontline therapy.

And so, one of LLS's goals is to educate patients, and physicians in the community that there are better therapies, experimental therapies coming in, and to get these patients on that experimental therapy will give better output.

And so, because we would like to get medicines out to the community setting and do clinical trials in the community setting, not only will that actually get hopefully better responses out in the community, but it will also get to the underserved community out there that requires therapy.

This transcription has been edited for clarity and conciseness.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.