The Leukemia and Lymphoma Society’s PedAL/EUpAL plans to conduct phase 1–2 clinical trials of menin inhibitor-based strategies in pediatric patients with relapsed or refractory AML or ALL carrying alterations in KMT2A, NPM1, or NUP98. These trials aim to establish safe and potentially effective pediatric dosages of ziftomenib in combination with appropriate multi-agent chemotherapy. The gene discussed is NPM1; the disease is acute lymphoblastic leukemia.