# Menin inhibitor + venetoclax + azacitidine

Source: https://onco.cc/pairings/menin-plus-venetoclax-hma/  
OnCo record `menin-plus-venetoclax-hma` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Combining the newest leukaemia drug class with the venetoclax backbone is producing remission rates in frontline NPM1 and KMT2A leukaemia that single agents never reached.

## Summary

This combination adds a menin inhibitor, ziftomenib or revumenib, to venetoclax and azacitidine as frontline treatment for acute myeloid leukaemia driven by NPM1 mutation or KMT2A rearrangement. Menin inhibition forces the leukaemia cells to differentiate and lowers their dependence on the BCL-2 family, venetoclax kills the primed cells, and azacitidine sensitises both steps. Early cohorts of KOMET-007 with ziftomenib and of the BEAT-AML and SAVE studies with revumenib report composite remission rates in newly diagnosed patients that single agents never reached, and phase 3 registration trials are under way; the evidence is phase 1 and 2 so far. Differentiation syndrome and cytopenias are the management challenge. The pairing builds on the VIALE-A and AUGMENT-101 papers.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Ziftomenib + Venetoclax
- Type: combination
- Rationale: Menin inhibition forces differentiation and lowers BCL-2 family dependence; venetoclax kills the primed cells; azacitidine sensitises both.
- Evidence: Phase 1/2; phase 3 ongoing.

## Sources

- ClinicalTrials.gov NCT02993523: VIALE-A: https://clinicaltrials.gov/study/NCT02993523

## Connected records

- cancers: [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia](https://onco.cc/cancers/aml-npm1-kmt2a/)
- targets: [KMT2A (MLL) rearrangement](https://onco.cc/targets/kmt2a/), [Menin](https://onco.cc/targets/menin/), [NPM1 mutation](https://onco.cc/targets/npm1/)
- drugs: [Azacitidine](https://onco.cc/drugs/azacitidine/), [Revumenib](https://onco.cc/drugs/revumenib/), [Venetoclax](https://onco.cc/drugs/venetoclax/), [Ziftomenib](https://onco.cc/drugs/ziftomenib/)
- key papers: [AUGMENT-101: revumenib, the first menin inhibitor, in relapsed leukaemias driven by KMT2A rearrangement or NPM1 mutation](https://onco.cc/key-papers/paper-augment-101-revumenib-menin-nature-2023/), [VIALE-A: venetoclax plus azacitidine for older adults with acute myeloid leukaemia who cannot have intensive chemotherapy](https://onco.cc/key-papers/paper-viale-a-venetoclax-azacitidine-nejm-2020/)

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