Jerald Radich, MD: AML Abstracts to Keep an Eye on at ASH 2023

In this episode of The HemOnc Pulse, Jerald Radich, MD, of the Fred Hutchinson Cancer Center, joined Chadi Nabhan, MD, MBA, FACP, to discuss various abstracts on acute myeloid leukemia (AML) presented at the 2023 American Society of Hematology (ASH) Annual Meeting & Exposition.

The conversation centered around menin inhibitors for the treatment of AML, the effect of measurable residual disease (MRD)-positivity on transplantation outcomes, and whether age plays a role in transplantation.

Abstract 57 investigated the menin inhibitor JNJ-75276617 in adult patients with relapsed or refractory AML harboring KMT2A alterations or NPM1 mutations. Dr. Radich said that the efficacy results are “promising,” as 63% of patients had a decrease in bone marrow blast population after a few cycles.

“This is surely something that is going in the next phase of trials,” he said.

Next, Dr. Radich talked about abstract 58, a phase I/II trial of the menin inhibitor revumenib in combination with decitabine/cedazuridine and venetoclax. All seven evaluable patients achieved complete response (CR), and three achieved MRD-negative status.

“That’s a really promising drug,” Dr. Radich reflected. “I would keep your eye out on that regimen and keep your eye on that poster.”

Next, Dr. Radich reflected on the “very common problem” of whether patients who have MRD after therapy should receive transplants knowing they have a higher risk of relapse. He discussed clinical evidence in which MRD positive patients who were transplanted had a survival rate of 60%, compared to 20% for MRD patients without transplant. Meanwhile, the survival rate was the same (around 70%) for patients who were MRD negative regardless of whether or not they received transplant.

“MRD positivity is an indication to go to transplant in these patients,” Dr. Radich said. “You can start using MRD as a marker of who needs to go to transplant or not.”