“…Pevonedistat (TAK-924/MLN4924) is an inhibitor of the NEDD8 activating enzyme (NAE), which suppresses neddylation and induces cell cycle arrest and apoptosis [ 139 ]. Moreover, it increases the accumulation of the pro-apoptotic protein NOXA, as well as the upregulation of PUMA, BIK, and BIM [ 140 , 141 , 142 ]. However, the phase III PANTHER study (NCT03268954) of pevonedistat plus azacitidine ( n = 227) vs azacitidine ( n = 227) in patients with newly diagnosed higher-risk MDS, higher-risk chronic myelomonocytic leukemia, or AML with 20–30% blasts, failed to reach pre-defined statistical significance for the primary endpoint of event-free survival (EFS) [ 143 ].…”