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DRUG CLASS:

Menin-MLL inhibitor

10d
The Effect of Food on the Pharmacokinetics of BN104 Tablets (clinicaltrials.gov)
P1, N=16, Not yet recruiting, BioNova Pharmaceuticals (Shanghai) LTD.
New P1 trial
14d
Journal
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NUP98 (Nucleoporin 98 And 96 Precursor 2)
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icovamenib (BMF-219)
17d
Pyoderma gangrenosum-like neutrophilic dermatosis as an adverse effect of menin-KMT2A inhibitor therapy for acute myeloid leukaemia. (PubMed, Ann Hematol)
A 71 years old woman received the MENi revumenib (REV) for relapsed/refractory NPM1m AML...However, to our knowledge, this is the first report ever of MENi induced PG-like ND and cutaneous involvement of DS. This report highlights the fact that ND such as PG, as a manifestation of DS, are a possibly severe adverse effect of MENi.
Journal • Adverse events
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KMT2A (Lysine Methyltransferase 2A)
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Revuforj (revumenib)
28d
AUGMENT-101: A Study of Revumenib in R/R Leukemias Including Those With an MLL/KMT2A Gene Rearrangement or NPM1 Mutation (clinicaltrials.gov)
P1/2, N=413, Recruiting, Syndax Pharmaceuticals | Trial completion date: Dec 2024 --> Dec 2027 | Trial primary completion date: Dec 2024 --> Dec 2027
Trial completion date • Trial primary completion date
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KMT2A (Lysine Methyltransferase 2A) • NUP98 (Nucleoporin 98 And 96 Precursor 2)
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NPM1 mutation • MLL rearrangement • MLL rearrangement • NUP98 rearrangement
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Revuforj (revumenib) • Tybost (cobicistat)
1m
COVALENT-111: Study of BMF-219 in Healthy Adult Subjects and in Adult Subjects With Type 2 Diabetes Mellitus (T2D) (clinicaltrials.gov)
P1/2, N=414, Active, not recruiting, Biomea Fusion Inc. | Suspended --> Active, not recruiting | Trial primary completion date: Jul 2024 --> Nov 2024
Enrollment closed • Trial primary completion date
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icovamenib (BMF-219)
2ms
BF-MNN-112: Phase 2 Trial of BMF-219 in Participants with Type 1 Diabetes Mellitus (clinicaltrials.gov)
P2, N=190, Active, not recruiting, Biomea Fusion Inc. | Suspended --> Active, not recruiting
Enrollment closed
|
icovamenib (BMF-219)
2ms
Menin-mll protein-protein interaction inhibitors: a patent review (2021-present). (PubMed, Expert Opin Ther Pat)
Therefore, new drug discovery strategy should be considered in advance. The expert opinion was proposed from several aspects, such as developing diverse chemical structures, discovering covalent inhibitors, designing small molecular PROTACs, and targeting the amino acids mutations for next-generation inhibitors.
Review • Journal
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NPM1 (Nucleophosmin 1) • KMT2A (Lysine Methyltransferase 2A)
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NPM1 mutation • KMT2A mutation
2ms
New P1 trial • Combination therapy • Stroma • Metastases
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imatinib • ziftomenib (KO-539)
2ms
Study of Radiolabeled Revumenib in Adults With Acute Leukemia (clinicaltrials.gov)
P1, N=8, Recruiting, Syndax Pharmaceuticals | Trial primary completion date: Sep 2024 --> Dec 2024
Trial primary completion date
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Revuforj (revumenib)
2ms
Revumenib in Combination With Azacitidine + Venetoclax in Patients NPM1-mutated or KMT2A-rearranged AML (clinicaltrials.gov)
P3, N=415, Not yet recruiting, Stichting Hemato-Oncologie voor Volwassenen Nederland
New P3 trial • Combination therapy
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NPM1 (Nucleophosmin 1)
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NPM1 mutation
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Venclexta (venetoclax) • azacitidine • Revuforj (revumenib)
3ms
Ziftomenib in relapsed or refractory acute myeloid leukaemia (KOMET-001): a multicentre, open-label, multi-cohort, phase 1 trial. (PubMed, Lancet Oncol)
Ziftomenib showed promising clinical activity with manageable toxicity in heavily pretreated patients with relapsed or refractory acute myeloid leukaemia. Phase 2 assessment of ziftomenib combination therapy in the upfront and relapsed or refractory setting is ongoing.
P1 data • Journal
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NPM1 (Nucleophosmin 1) • KMT2A (Lysine Methyltransferase 2A)
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NPM1 mutation • KMT2A rearrangement • MLL rearrangement • MLL mutation
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ziftomenib (KO-539)
3ms
Enrollment open
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Venclexta (venetoclax) • Revuforj (revumenib)
3ms
Ziftomenib Maintenance Post Allo-HCT (clinicaltrials.gov)
P1, N=22, Recruiting, Massachusetts General Hospital | Not yet recruiting --> Recruiting
Enrollment open
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ziftomenib (KO-539)
3ms
A Phase I-II Study Investigating the All Oral Combination of the Menin Inhibitor SNDX-5613 With Decitabine/Cedazuridine (ASTX727) and Venetoclax in Acute Myeloid Leukemia (SAVE) (clinicaltrials.gov)
P1/2, N=43, Recruiting, M.D. Anderson Cancer Center | Trial completion date: Dec 2024 --> Dec 2026 | Trial primary completion date: Dec 2024 --> Dec 2026
Trial completion date • Trial primary completion date
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Venclexta (venetoclax) • Revuforj (revumenib) • Inqovi (decitabine/cedazuridine)
3ms
The histone methyltransferase mixed-lineage-leukemia-1 drives T cell phenotype via notch signaling in diabetic tissue repair. (PubMed, JCI Insight)
Treatment of diabetic wound CD4T cells with a small molecule inhibitor of MLL1 (MI-2) yielded a significant reduction in CD4+TH17 cells and IL17A. This is the first study to identify the MLL1-mediated mechanisms responsible for regulating the TH17/Treg balance in normal and diabetic wounds and define the complex role of Notch signaling in CD4+T cells in wounds, where increased or decreased Notch signaling both result in pathologic wound repair. Therapeutic targeting of MLL1 in diabetic CD4+TH cells may decrease pathologic inflammation through regulation of CD4+T cell differentiation.
Journal • Epigenetic controller
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CD4 (CD4 Molecule) • IL17A (Interleukin 17A)
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MI-2
4ms
Foundation Medicine Partners with Syndax to Develop a Companion Diagnostic in Hematology and Support Efforts to Pursue Regulatory Approval for an Assay Based on the FoundationOne Heme Platform (Businesswire)
"Foundation Medicine, Inc. today announced a collaboration with Syndax Pharmaceuticals...to develop a companion diagnostic for the identification of acute myeloid leukemia (AML) patients harboring an NPM1 mutation. As part of the collaboration, Syndax will also support Foundation Medicine’s efforts to pursue regulatory approval of an assay based on the FoundationOne Heme platform....If approved, the assay could be the first next-generation sequencing companion diagnostic to detect genomic alterations in hematologic neoplasms, including enhancing the identification of patients with NPM1 mutations who may be eligible for revumenib."
Licensing / partnership
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FoundationOne® Heme CDx
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Revuforj (revumenib)
4ms
New P1 trial • Post-transplantation
|
clonoSEQ
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Revuforj (revumenib)
4ms
Trial completion • Combination therapy
|
KMT2A (Lysine Methyltransferase 2A) • NUP98 (Nucleoporin 98 And 96 Precursor 2)
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cytarabine • cyclophosphamide • Revuforj (revumenib)
4ms
Menin Inhibition With Revumenib for KMT2A-Rearranged Relapsed or Refractory Acute Leukemia (AUGMENT-101). (PubMed, J Clin Oncol)
Revumenib led to high remission rates with a predictable safety profile in R/R KMT2Ar acute leukemia. To our knowledge, this trial represents the largest evaluation of a targeted therapy for these patients.
Journal
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NPM1 (Nucleophosmin 1) • KMT2A (Lysine Methyltransferase 2A)
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Revuforj (revumenib)
5ms
Revumenib for patients with acute leukemia: a new tool for differentiation therapy. (PubMed, Haematologica)
It will focus on the pathophysiology of leukemias sensitive to menin inhibition, delineation of how this understanding led to targeted drug development, and data from clinical trials. The important discovery of resistance mechanisms will also be explored, as well as future directions in using menin inhibitors for treating leukemia.
Journal
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NPM1 (Nucleophosmin 1) • KMT2A (Lysine Methyltransferase 2A)
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Revuforj (revumenib)
5ms
Enrollment open • Trial initiation date
5ms
Study of Radiolabeled Revumenib in Adults With Acute Leukemia (clinicaltrials.gov)
P1, N=8, Recruiting, Syndax Pharmaceuticals | Trial completion date: Sep 2024 --> Dec 2024 | Trial primary completion date: May 2024 --> Sep 2024
Trial completion date • Trial primary completion date
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Revuforj (revumenib)
6ms
Design of Inhibitors That Target the Menin-Mixed-Lineage Leukemia Interaction. (PubMed, Computation (Basel))
Additionally, these compounds were predicted as antileukemic, antineoplastic, chemopreventive, and apoptotic agents. The 10 natural compounds can be further explored as potential novel agents for the effective treatment of MLL-mediated leukemia.
Journal
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KMT2A (Lysine Methyltransferase 2A)
6ms
A Phase II Study of the Menin Inhibitor Revumenib in Leukemia Associated With Upregulation of HOX Genes (clinicaltrials.gov)
P2, N=15, Recruiting, M.D. Anderson Cancer Center | Not yet recruiting --> Recruiting
Enrollment open
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Revuforj (revumenib)
6ms
A Clinical Study of HMPL-506 in Patients With Hematological Malignancies (clinicaltrials.gov)
P1, N=98, Recruiting, Hutchmed | Not yet recruiting --> Recruiting
Enrollment open
|
HOXA9 (Homeobox A9) • ITGAM (Integrin, alpha M)
6ms
Distinct Responses to Menin Inhibition and Synergy with DOT1L Inhibition in KMT2A-Rearranged Acute Lymphoblastic and Myeloid Leukemia. (PubMed, Int J Mol Sci)
Finally, we demonstrate significant synergy between revumenib and the DOT1L inhibitor pinometostat in KMT2A-rearranged ALL, suggesting that such drug combinations represent a potent therapeutic strategy for these patients. Collectively, our findings underscore the complexity of resistance mechanisms and advocate for precise patient stratification to optimize the use of menin inhibitors in KMT2A-rearranged acute leukemia.
Journal
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KMT2A (Lysine Methyltransferase 2A) • DOT1L (DOT1 Like Histone Lysine Methyltransferase) • MEN1 (Menin 1)
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Revuforj (revumenib) • pinometostat (EPZ-5676)
6ms
BF-MNN-112: Phase 2 Trial of BMF-219 in Participants With Type 1 Diabetes Mellitus (clinicaltrials.gov)
P2, N=190, Suspended, Biomea Fusion Inc. | Recruiting --> Suspended
Trial suspension
|
icovamenib (BMF-219)
6ms
Trial suspension
|
icovamenib (BMF-219)
6ms
Synergistic effects of the KDM4C inhibitor SD70 and the menin inhibitor MI-503 against MLL::AF9-driven acute myeloid leukaemia. (PubMed, Br J Haematol)
Differential gene expression analysis by RNA-seq following combined pharmacological inhibition of SD70 and MI-503 revealed changes in numerous genes, with MYC target genes being the most significantly downregulated. Taken together, these data provide preclinical evidence that the combination of SD70 and MI-503 is a potential dual-targeted therapy for MLL::AF9 AML.
Journal
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KMT2A (Lysine Methyltransferase 2A) • CD34 (CD34 molecule)
|
MI-503
6ms
New P1 trial
|
Venclexta (venetoclax) • Mylotarg (gemtuzumab ozogamicin) • ziftomenib (KO-539)
7ms
Ziftomenib Maintenance Post Allo-HCT (clinicaltrials.gov)
P1, N=22, Not yet recruiting, Massachusetts General Hospital
New P1 trial
|
ziftomenib (KO-539)
8ms
New P1 trial
|
Venclexta (venetoclax) • azacitidine • ziftomenib (KO-539)
8ms
New P1 trial
|
HOXA9 (Homeobox A9) • ITGAM (Integrin, alpha M)
8ms
A 2024 Update on Menin Inhibitors. A New Class of Target Agents against KMT2A-Rearranged and NPM1-Mutated Acute Myeloid Leukemia. (PubMed, Hematol Rep)
To date, this new class of drugs has been tested in phase I and II clinical trials, both alone and in combination with synergistic drugs showing promising results in terms of response rates and safety in heavily pre-treated acute leukemia patients. In this brief review, we summarize the key findings on menin inhibitors, focusing on the mechanism of action and preliminary clinical data on the treatment of acute myeloid leukemia with this promising new class of agents, particularly revumenib and ziftomenib.
Review • Journal
|
NPM1 (Nucleophosmin 1) • KMT2A (Lysine Methyltransferase 2A) • MEIS1 (Meis Homeobox 1)
|
NPM1 mutation • MLL rearrangement • KMT2A expression
|
Revuforj (revumenib) • ziftomenib (KO-539)
8ms
Enrollment open
|
Venclexta (venetoclax) • cytarabine • azacitidine • methotrexate • Revuforj (revumenib)
8ms
New P1 trial • Combination therapy
|
cytarabine • ziftomenib (KO-539) • fludarabine IV
8ms
Arachidonic acid released by PIK3CA mutant tumor cells triggers malignant transformation of colonic epithelium by inducing chromatin remodeling. (PubMed, Cell Rep Med)
Finally, the combination of VTP50469, an inhibitor of the Menin-MLL interaction, and alpelisib synergistically represses PDX tumors harboring PIK3CA mutations. Together, these findings unveil the metabolic link between PIK3CA mutant tumor cells and the IECs, highlighting AA as the potential target for the treatment of patients with CRC harboring PIK3CA mutations.
Journal • Tumor cell
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PIK3CA (Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) • FBXW7 (F-Box And WD Repeat Domain Containing 7)
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PIK3CA mutation
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Piqray (alpelisib) • VTP-50469
8ms
Synergistic Effects of the RARalpha Agonist Tamibarotene and the Menin Inhibitor Revumenib in Acute Myeloid Leukemia Cells with KMT2A Rearrangement or NPM1 Mutation. (PubMed, Cancers (Basel))
The impact of revumenib on KMT2Ar or NPM1c AML cells was significantly enhanced when combined with tamibarotene, demonstrating synergistic differentiation or apoptosis initiation. These findings propose promising strategies for relapsed/refractory AML patients with defined molecular characteristics.
Journal
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NPM1 (Nucleophosmin 1) • KMT2A (Lysine Methyltransferase 2A) • RARA (Retinoic Acid Receptor Alpha) • CDK6 (Cyclin-dependent kinase 6) • CEBPA (CCAAT Enhancer Binding Protein Alpha)
|
NPM1 mutation • KMT2A rearrangement • MLL rearrangement
|
Revuforj (revumenib) • Amnolake (tamibarotene)
9ms
Enrollment open • Combination therapy
|
cytarabine • Revuforj (revumenib)
9ms
Enrollment open • Combination therapy
|
KMT2A (Lysine Methyltransferase 2A)
|
MLL rearrangement
|
cytarabine • methotrexate • vincristine • Revuforj (revumenib) • fludarabine IV • Asparlas (calaspargase pegol-mknl) • Starasid (cytarabine ocfosfate)
9ms
New P1 trial • Combination therapy
|
Rydapt (midostaurin) • daunorubicin • Revuforj (revumenib)