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A panelist discusses how ASCO 2025's most important breakthrough was the oral decitabine plus venetoclax combination, representing a potential paradigm shift if approved by the FDA, while highlighting that menin inhibitors (including the already-approved revumenib and pipeline agents like ziftomenib, bleximenib, and enzomenib) are the most exciting emerging therapies targeting 40% to 50% of patients with acute myeloid leukemia with NPM1 mutations or KMT2A rearrangements, though significant therapeutic gaps remain for challenging subgroups like TP53-mutated disease.

1 expert is featured in this series.

A panelist discusses how a large propensity score–matched analysis of 1300 patients aged 60-75 found similar all-cause mortality between intensive chemotherapy and azacitidine plus venetoclax, but with lower adverse events in the azacitidine-venetoclax group, suggesting that treatment selection should be individualized based on patient fitness, genetic mutations, transplant candidacy, and patient preferences for time-limited vs continuous therapy, while emphasizing the need for prospective randomized trials to definitively guide treatment decisions in this age group.

1 expert in this video

An expert discusses how different adverse event profiles of antibody-drug conjugates (ADCs) influence treatment decisions by requiring careful patient selection based on comorbidities like prior lung disease, implementing baseline assessments and monitoring protocols for pneumonitis and ocular toxicities, and recognizing that early detection and management of adverse effects allows for continued treatment through dose modifications.

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An expert discusses how clinicians and institutions can streamline biomarker-driven therapy decisions by establishing rapid turnaround times for biopsies and pathology results, maintaining in-house testing capabilities, coordinating efficiently between interventional radiology and pathology teams, and ensuring insurance approvals don’t delay treatment initiation for patients who may deteriorate quickly.

4 experts in this video

Panelists discuss how NCCN guidelines are expected to incorporate quadruplet-based regimens as reasonable treatment approaches for transplant-ineligible patients, while emphasizing the need for personalized treatment strategies that consider individual patient frailty and high-risk genetics rather than applying uniform approaches across all older patients.

4 experts in this video

Panelists discuss how the CEPHEUS trial demonstrated that quadruplet therapy (daratumumab, bortezomib, lenalidomide, and dexamethasone) significantly improved minimal residual disease negativity rates compared to triplet therapy in transplant-ineligible multiple myeloma patients, achieving approximately 60% vs 47% 10–5 responses while maintaining manageable safety profiles.

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