Broader Advances in AML: Triplets, Oral Regimens, and Expanding MRD-Guided Strategies

This segment shifts toward the broader excitement in AML therapeutics beyond induction paradigms, focusing on emerging triplet strategies, fully oral regimens, and longer-term survival improvements demonstrated in recent clinical trials. The panel begins by highlighting ongoing work with oral therapy combinations, particularly regimens built from menin inhibitors paired with oral HMAs. These “all-oral” strategies have shown promising response rates and may offer patients more flexibility, reduced clinic time, and improved quality of life.

The discussion then moves to the azacitidine–venetoclax–gilteritinib triplet, with data from MD Anderson demonstrating nearly tripled overall survival compared with azacitidine–venetoclax alone in FLT3-positive patients. The panel emphasizes the importance of dosing finesse, adjusting schedules to maintain tolerability without sacrificing efficacy, an area in which MD Anderson has pioneered practical algorithms. They also mention the upcoming VICEROY multicenter data, reinforcing that such regimens can succeed beyond single-center expertise.

The panel notes that these advancements lay the groundwork for a future where targeted triplets may be increasingly common in both older and younger patients with AML, particularly those with actionable mutations such as IDH1/2, KMT2A rearrangements, FLT3, and NPM1. As survival improves, the role of MRD testing becomes even more critical. New MRD tools, including highly sensitive assays for KMT2A-rearranged AML, promise to refine decision-making around treatment continuation, intensification, and transplant timing.

The AML field is expanding rapidly, with multiple therapeutic avenues (oral regimens, triplets, mutation-driven strategies, and advanced MRD monitoring) working together to reshape both induction and consolidation strategies.