Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacy

<h3>Background</h3><p dir="ltr">Menin inhibitors represent a novel therapeutic approach targeting the Menin-KMT2A interaction in acute leukemias with KMT2A rearrangements or NPM1 mutations. This scoping review synthesizes current clinical evidence for emerging Menin inhib...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Sara Al Dali (22504094) (author)
مؤلفون آخرون: Abdulrahman F. Al-Mashdali (17148316) (author), Anas Kalfah (22504097) (author), Shehab F. Mohamed (17945561) (author)
منشور في: 2025
الموضوعات:
الوسوم: إضافة وسم
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author Sara Al Dali (22504094)
author2 Abdulrahman F. Al-Mashdali (17148316)
Anas Kalfah (22504097)
Shehab F. Mohamed (17945561)
author2_role author
author
author
author_facet Sara Al Dali (22504094)
Abdulrahman F. Al-Mashdali (17148316)
Anas Kalfah (22504097)
Shehab F. Mohamed (17945561)
author_role author
dc.creator.none.fl_str_mv Sara Al Dali (22504094)
Abdulrahman F. Al-Mashdali (17148316)
Anas Kalfah (22504097)
Shehab F. Mohamed (17945561)
dc.date.none.fl_str_mv 2025-06-03T06:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.critrevonc.2025.104783
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Menin_inhibitors_in_KMT2A-rearranged_and_NPM1-mutated_acute_leukemia_A_scoping_review_of_safety_and_efficacy/30455843
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biological sciences
Genetics
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Oncology and carcinogenesis
Pharmacology and pharmaceutical sciences
Menin inhibitors
KMT2A rearrangement
NPM1 mutation
Acute leukemia
Targeted therapy
Clinical trials
dc.title.none.fl_str_mv Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacy
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Menin inhibitors represent a novel therapeutic approach targeting the Menin-KMT2A interaction in acute leukemias with KMT2A rearrangements or NPM1 mutations. This scoping review synthesizes current clinical evidence for emerging Menin inhibitors in development. </p><h3>Methods</h3><p dir="ltr">We systematically analyzed clinical trials, conference proceedings, and regulatory documents regarding Menin inhibitors in clinical development through December 2024. Primary outcomes included response rates, minimal residual disease (MRD) status, and safety profiles. </p><h3>Results</h3><p dir="ltr">Thirteen clinical trials investigating six Menin inhibitors (Revumenib, Ziftomenib, Bleximenib, BMF-219, DS-1594, and Enzomenib) were identified. Revumenib demonstrated consistent efficacy across five pivotal trials, achieving MRD-negative rates of 70–90 % in both KMT2A-rearranged and NPM1-mutated leukemias, leading to FDA approval in November 2024. Ziftomenib showed particular efficacy in NPM1-mutated cases but exhibited a higher incidence of differentiation syndrome (30 %) in KMT2A-rearranged patients. Bleximenib reported a 93 % overall response rate, pending MRD validation. Early resistance emergence, primarily through MEN1 mutations, was observed across trials, emerging as early as two treatment cycles. </p><h3>Conclusions</h3><p dir="ltr">Menin inhibitors demonstrate promising clinical activity in molecularly defined leukemias, with Revumenib establishing proof-of-concept for this therapeutic approach. However, challenges remain, including resistance development, optimal timing of therapy initiation, and determination of effective combination strategies. Larger randomized trials with extended follow-up are needed to establish long-term efficacy and safety profiles. The rapid clinical development of multiple agents in this class suggests an expanding role for Menin inhibitors in leukemia treatment paradigms.</p><h2>Other Information</h2><p dir="ltr">Published in: Critical Reviews in Oncology/Hematology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.critrevonc.2025.104783" target="_blank">https://dx.doi.org/10.1016/j.critrevonc.2025.104783</a></p>
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identifier_str_mv 10.1016/j.critrevonc.2025.104783
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oai_identifier_str oai:figshare.com:article/30455843
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spelling Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacySara Al Dali (22504094)Abdulrahman F. Al-Mashdali (17148316)Anas Kalfah (22504097)Shehab F. Mohamed (17945561)Biological sciencesGeneticsBiomedical and clinical sciencesCardiovascular medicine and haematologyOncology and carcinogenesisPharmacology and pharmaceutical sciencesMenin inhibitorsKMT2A rearrangementNPM1 mutationAcute leukemiaTargeted therapyClinical trials<h3>Background</h3><p dir="ltr">Menin inhibitors represent a novel therapeutic approach targeting the Menin-KMT2A interaction in acute leukemias with KMT2A rearrangements or NPM1 mutations. This scoping review synthesizes current clinical evidence for emerging Menin inhibitors in development. </p><h3>Methods</h3><p dir="ltr">We systematically analyzed clinical trials, conference proceedings, and regulatory documents regarding Menin inhibitors in clinical development through December 2024. Primary outcomes included response rates, minimal residual disease (MRD) status, and safety profiles. </p><h3>Results</h3><p dir="ltr">Thirteen clinical trials investigating six Menin inhibitors (Revumenib, Ziftomenib, Bleximenib, BMF-219, DS-1594, and Enzomenib) were identified. Revumenib demonstrated consistent efficacy across five pivotal trials, achieving MRD-negative rates of 70–90 % in both KMT2A-rearranged and NPM1-mutated leukemias, leading to FDA approval in November 2024. Ziftomenib showed particular efficacy in NPM1-mutated cases but exhibited a higher incidence of differentiation syndrome (30 %) in KMT2A-rearranged patients. Bleximenib reported a 93 % overall response rate, pending MRD validation. Early resistance emergence, primarily through MEN1 mutations, was observed across trials, emerging as early as two treatment cycles. </p><h3>Conclusions</h3><p dir="ltr">Menin inhibitors demonstrate promising clinical activity in molecularly defined leukemias, with Revumenib establishing proof-of-concept for this therapeutic approach. However, challenges remain, including resistance development, optimal timing of therapy initiation, and determination of effective combination strategies. Larger randomized trials with extended follow-up are needed to establish long-term efficacy and safety profiles. The rapid clinical development of multiple agents in this class suggests an expanding role for Menin inhibitors in leukemia treatment paradigms.</p><h2>Other Information</h2><p dir="ltr">Published in: Critical Reviews in Oncology/Hematology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.critrevonc.2025.104783" target="_blank">https://dx.doi.org/10.1016/j.critrevonc.2025.104783</a></p>2025-06-03T06:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.critrevonc.2025.104783https://figshare.com/articles/journal_contribution/Menin_inhibitors_in_KMT2A-rearranged_and_NPM1-mutated_acute_leukemia_A_scoping_review_of_safety_and_efficacy/30455843CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/304558432025-06-03T06:00:00Z
spellingShingle Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacy
Sara Al Dali (22504094)
Biological sciences
Genetics
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Oncology and carcinogenesis
Pharmacology and pharmaceutical sciences
Menin inhibitors
KMT2A rearrangement
NPM1 mutation
Acute leukemia
Targeted therapy
Clinical trials
status_str publishedVersion
title Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacy
title_full Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacy
title_fullStr Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacy
title_full_unstemmed Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacy
title_short Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacy
title_sort Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacy
topic Biological sciences
Genetics
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Oncology and carcinogenesis
Pharmacology and pharmaceutical sciences
Menin inhibitors
KMT2A rearrangement
NPM1 mutation
Acute leukemia
Targeted therapy
Clinical trials