What is the future of acute myeloid leukemia treatment?

What do you see as the future of AML treatments? So in my view, the future of AML treatments is to focus further on research that helps us understand the biology that's driving the leukemia in individual patients and marry that with better targeted therapies that can be more effective at controlling the disease for a longer period. That may or may not mean a cure for many patients. Cure is still the overall goal for a large portion, but when we think that cure is not in the cards for that individual patient, it doesn't mean that we don't have effective therapy that can give them meaningful quality time beyond the months that they would have, hopefully for many years. The newer therapies that might help us most are focused on not developing just standard chemotherapy, but trying to develop medications that target the bad pathways driving the disease, as well as medications that affect the immune system and help the immune system to directly attack the leukemia. And together, we're able to make great strides recently in leukemia therapy. Well, I'm hopeful that the future of AML treatment is heading to both better tolerated, meaning fewer side effects in terms of our treatments, but certainly much more effective treatments. We've come a long way and patients are living longer, feeling better. But I would say until we are curing more patients, and especially curing them without bone marrow transplants. Bone marrow transplant is a tough thing to go through even for a young person, but the majority of AML patients are older and are not candidates for bone marrow transplants. And so I would hope that in my lifetime that we are curing AML without bone marrow transplant and with treatments that even your 85-year-old grandma could get through. We have made a lot of progress, and I say that because I have a whole group of 80 and 90-year-olds that are getting AML treatment with me and living really high quality lives. And so, yeah, expanding the number of patients that we can treat safely and successfully to cure. AML treatment has become incredibly personalized in just the last couple of years. We went from next generation sequencing testing really being an exploratory research type of a tool to now ultimately being effectively a standard of care practice when we're seeing and evaluating patients with myeloid malignancies like AML. So when I see a patient with this disease, I'm basically fingerprinting their unique cancer case. And we're learning about the specific mutations that might be driving the growth of that person's disease or that help us to better understand the likelihood of it responding to one therapy or another or that help us better understand whether there might need to be a role for more aggressive treatments like a stem cell transplant to increase the likelihood that we could cure that person's AML. So we've moved from a kind of one size fits all or two size fits all approach historically where we had either just high dose or low dose therapy to now a much more nuanced approach where depending on what we find with the molecular profiling, we may do any number of different things for each unique patient. And that means it's particularly important now for us to better understand not only the drivers of the disease biologically, but also actually that person's health, their fitness, their goals, their values, their preferences, and to really follow more of a shared decision making process to figure out the right plan for each person and situation and family. I'm very excited about another class of agents, men and inhibitors, and those inhibitors are targeting the biology of NPM1 mutant and MLL or KTM2A gene rearranged AML and ALL. Those inhibitors have been published or presented last as well as this as and is showing a remarkable amount of biological activity. We're also seeing targeted antibodies. We're seeing antibody drug conjugates which are bringing toxins or radiation directly to leukemia cells, and we're seeing a number of novel immunotherapies. I think immunotherapy finally is starting to make a difference in AML, but not once targeting T cells necessarily, but other mechanisms. Macrophages, the bone marrow microenvironment, so CD47 and TEM3A are some novel immunotherapeutic targets that we're looking at with antibodies. Very very excited. All of these are non cytotoxic drugs, not conventional chemo, and kind of I think represent where we're going.