Acute leukemias, notably acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), are aggressive hematologic malignancies characterized by dysregulated hematopoietic proliferation, often linked to rearrangements in KMT2A (lysine methyltransferase 2A). Syndax Pharmaceuticals has developed revumenib, the first FDA-approved menin inhibitor, which disrupts menin's interaction with oncogenic partners driving leukemia cell growth. This targeted approach shows promise in genetically defined subsets of AML and ALL patients, including those with KMT2A rearrangements, NPM1 mutations, and NUP98 rearrangements, addressing significant unmet clinical needs by offering a novel therapeutic mechanism beyond conventional chemotherapy.