NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia: the decisions you may face

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

1. Between Cytarabine + anthracycline ('7+3'), Allogeneic stem cell transplantation and NGS-based MRD (clonoSEQ and molecular MRD), which do you recommend for me, and what about my case would make you choose differently?
   Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
2. What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
   Why: The aim shapes how much side effect and disruption is worth accepting.
3. What happens if I delay, or decline this step for now? Is the decision reversible?
   Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
4. Does your recommendation follow the current guideline (NCCN Guidelines: Acute Myeloid Leukemia), and if it departs from it, why?
   Why: Departures from guidelines are sometimes right for an individual; they should be explained.
5. For my situation (newly diagnosed, fit for intensive chemotherapy), which of the standard options do you recommend and why?
   Why: Guideline options include: 7+3 induction with consolidation; NPM1 MRD monitoring decides transplant in favourable-risk disease; transplant in first remission for KMT2A-rearranged and FLT3-ITD co-mutated disease.
6. Am I a candidate for Cytarabine + anthracycline ('7+3'), and what side effects should I expect?
   Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.

• VIALE-APhase 3NCT029935232020443 peopleevidence 93
  Tests Venetoclax, Azacitidine
  Newly diagnosed AML unfit for intensive chemotherapy: venetoclax + azacitidine vs placebo + azacitidine

  OS 14.7 vs 9.6 months, HR 0.66; CR 36.7% vs 17.9%.

  Overall survival (median) (months): Venetoclax + azacitidine 14.7 (n=286) vs Placebo + azacitidine 9.6 (n=145) · HR 0.66 · source

1. Between Venetoclax and Azacitidine, which do you recommend for me, and what about my case would make you choose differently?
   Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
2. What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
   Why: The aim shapes how much side effect and disruption is worth accepting.
3. How closely do I match the people in VIALE-A, and does that change what the results mean for me?
   Why: Trial populations are selected; age, fitness, prior treatment and biomarkers all affect how far results carry.
4. Which side effects of Azacitidine are most likely for me, which are reversible, and which would make us stop?
   Why: The recorded rates below come from labels and trials; your own risk depends on dose, other medicines and your health.
5. What happens if I delay, or decline this step for now? Is the decision reversible?
   Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
6. Does your recommendation follow the current guideline (NCCN Guidelines: Acute Myeloid Leukemia), and if it departs from it, why?
   Why: Departures from guidelines are sometimes right for an individual; they should be explained.
7. For my situation (newly diagnosed, unfit for intensive chemotherapy), which of the standard options do you recommend and why?
   Why: Guideline options include: Venetoclax plus azacitidine, with a menin inhibitor added in trials.
8. Am I a candidate for Venetoclax, Azacitidine, and what side effects should I expect?
   Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
9. How do the results of VIALE-A apply to someone like me?
   Why: Trial populations differ from individual patients; ask how closely you match.

Add these to your appointment list, or take the full question set for this cancer.

• AUGMENT-101Phase 1/2NCT04065399202494 peopleevidence 56
  Tests Revumenib
  Relapsed/refractory KMT2A-rearranged or NPM1-mutated acute leukaemia: revumenib monotherapy

  CR+CRh 22.8%, ORR 63.2% in KMT2Ar cohort.

  CR + CRh (KMT2Ar cohort) (%): Revumenib 22.8 (n=57) · source
• KOMET-001Phase 1/2NCT040673362025112 peopleevidence 56
  Tests Ziftomenib
  Relapsed/refractory NPM1-mutated AML: ziftomenib 600 mg daily monotherapy
  ▸Show survival figures (1)

  Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.

  • CR 23%, ORR 33%, median OS 6.6 months.
  Complete remission (%): Ziftomenib 23 (n=112) · source

1. Between Revumenib, Ziftomenib and Allogeneic stem cell transplantation, which do you recommend for me, and what about my case would make you choose differently?
   Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
2. What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
   Why: The aim shapes how much side effect and disruption is worth accepting.
3. How closely do I match the people in AUGMENT-101 and KOMET-001, and does that change what the results mean for me?
   Why: Trial populations are selected; age, fitness, prior treatment and biomarkers all affect how far results carry.
4. What happens if I delay, or decline this step for now? Is the decision reversible?
   Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
5. Does your recommendation follow the current guideline (NCCN Guidelines: Acute Myeloid Leukemia), and if it departs from it, why?
   Why: Departures from guidelines are sometimes right for an individual; they should be explained.
6. For my situation (relapsed or refractory), which of the standard options do you recommend and why?
   Why: Guideline options include: Revumenib (KMT2A-rearranged or NPM1-mutated) or ziftomenib (NPM1-mutated) as a bridge to allogeneic transplant; menin inhibitor combinations in trials.
7. Am I a candidate for Revumenib, Ziftomenib, and what side effects should I expect?
   Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
8. How do the results of AUGMENT-101 and KOMET-001 apply to someone like me?
   Why: Trial populations differ from individual patients; ask how closely you match.

Add these to your appointment list, or take the full question set for this cancer.