Although a phase 2 study of azacitidine with or without birinapant failed to demonstrate a difference in response rate between the two arms in genetically unselected myeloid malignancy patients59, we encourage the development of direct CFLAR inhibitors and the further clinical evaluation of SMAC-mimetics in -7/del(7q) myeloid malignancies. The gene discussed is CFLAR; the disease is myeloid neoplasm.