What is the treatment approach if an AML patient receiving azacitidine/venetoclax is later found to have FLT3 and IDH2 mutations?

This is solely an opinion as there is little data. Since FLT3 inhibitors are not approved for use with azacitidine and venetoclax and data is just emerging about triplet therapy with the addition of these inhibitors, I would just keep going with azacitidine and venetoclax and reserve FLT3 and IDH2 inhibitors for a time when response to the original therapy is lost. If those mutations persist after cycles of aza/ven, they could be utilized at that time. Their use as maintenance would be of interest too but more data about that is needed as well. I would not switch to azacitidine with enasidenib after azacitidine/venetoclax has already been started, unless there is a lack of an adequate response.