(R)-N-ETHYL-5-FLUORO-N-ISOPROPYL-2-((5-(2-(6-((2-METHOXYETHYL)(METHYL)AMINO)-2-METHYLHEXANE-3-YL)-2,6-DIAZASPIRO[3.4]OCTAN-6-YL)-1,2,4-TRIAZIN-6-YL)OXY)BENZAMIDE, ITS COMPOSITIONS AND ADMINISTRATION ROUTES FOR USE IN THE TREATMENT OF CANCER
Patent Information
- Authority / Receiving Office
- RU · RU
- Patent Type
- Applications
- Current Assignee / Owner
- JANSSEN PHARMA NV
- Filing Date
- 2024-10-17
- Publication Date
- 2026-06-30
AI Technical Summary
Current treatments for acute leukemias with KMT2A, NPM1, NUP98, or NUP214 alterations are limited, often resulting in poor outcomes due to the aggressive nature of these diseases and the lack of effective therapeutic approaches.
The use of (R) -N-ethyl-5-fluoro-N-isopropyl-2-((5-(2-(6-((2-methoxyethyl)(methyl)amino)-2-methylhexan-3-yl)-2,6-diazaspiro[3.4]octan-6-yl)-1,2,4-triazin-6-yl)oxy)benzamide, a potent and selective inhibitor of the menin/MLL interaction, administered in specific dosage regimens to target the menin/MLL interaction in cancer cells.
The described compound effectively reduces the incidence and severity of adverse events such as differentiation syndrome while achieving therapeutic efficacy in treating cancers, including relapsed/refractory acute leukemias, by disrupting the menin/MLL interaction.
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Abstract
Description
(R) -N-ETHYL-5-FLUORO-N-ISOPROPYL-2- ( (5- (2- (6- ( (2-METHOXYETHYL) (METHYL) AMINO) -2-METHYLHEXAN-3-YL) -2, 6-DIAZASPIRO [3.4] OCTAN-6-YL) -1, 2, 4-TRIAZIN-6-YL) OXY) BENZAMIDE, FORMULATIONS AND DOSAGE REGIMENS THEREOF, FOR USE IN TREATING CANCERCLAIM OF PRIORITYThis application claims priority to PCT / CN2023 / 125622 filed on October 20, 2023, PCT / CN2023 / 127293 filed on October 27, 2023, PCT / CN2023 / 127557 filed on October 30, 2023, PCT / CN2023 / 137435 filed on December 8, 2023, PCT / CN2024 / 078096 filed on February 22, 2024, PCT / CN2024 / 089391 filed on April 23, 2024, PCT / CN2024 / 093111 filed on May 14, 2024, PCT / CN2024 / 098957 filed on June 13, 2024, PCT / CN2024 / 103581 filed on July 4, 2024, each of which is incorporated by reference in its entirety.FIELD OF THE INVENTIONThe present invention relates to (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, and pharmaceutically acceptable salts and solvates thereof, formulations and dosage regimens thereof, for use in treating cancer.BACKGROUND OF THE INVENTIONChromosomal rearrangements affecting the mixed lineage leukemia gene (MLL; MLL1; KMT2A) result in aggressive acute leukemias across all age groups and still represent mostly incurable diseases emphasizing the urgent need for novel therapeutic approaches. Acute leukemias harboring these chromosomal translocations of MLL represent as lymphoid, myeloid or biphenotypic disease and constitute 5 to 10%of acute leukemias in adults and approximately 70%in infants.MLL is a histone methyltransferase that methylates histone H3 on lysine 4 (H3K4) and functions in multiprotein complexes. Use of inducible loss-of-function alleles of Mll1 demonstrated that Mll1 plays an essential role in sustaining hematopoietic stem cells (HSCs) and developing B cells although its histone methyltransferase activity is dispensable for hematopoiesis.Fusion of MLL with more than 60 different partners has been reported to date and has been associated with leukemia formation / progression. Interestingly, the SET (Su (var) 3–9, enhancer of zeste, and trithorax) domain of MLL is not retained in chimeric proteins but is replaced by the fusion partner. Recruitment of chromatin modifying enzymes like Dot1L and / or the pTEFb complex by the fusion partner leads to enhanced transcription and transcriptional elongation of MLL target genes including HOXA genes (e.g. HOXA9) and the HOX cofactor MEIS1 as the most prominent ones. Aberrant expression of these genes in turn blocks hematopoietic differentiation and enhances proliferation.Menin which is encoded by the Multiple Endocrine Neoplasia type 1 (MEN1) gene is expressed ubiquitously and is predominantly localized in the nucleus. It has been shown to interact with numerous proteins and is, therefore, involved in a variety of cellular processes. The best understood function of menin is its role as an oncogenic cofactor of MLL fusion proteins. Menin interacts with two motifs within the N-terminal fragment of MLL that is retained in all fusion proteins, MBM1 (menin-binding motif 1) and MBM2. Menin / MLL interaction leads to the formation of a new interaction surface for lens epithelium-derived growth factor (LEDGF) . Although MLL directly binds to LEDGF, menin is obligatory for the stable interaction between MLL and LEDGF and the gene specific chromatin recruitment of the MLL complex via the PWWP domain of LEDGF. Furthermore, numerous genetic studies have shown that menin is strictly required for oncogenic transformation by MLL fusion proteins suggesting the menin / MLL interaction as an attractive therapeutic target. For example, conditional deletion of Men1 prevents leukomogenesis in bone marrow progenitor cells ectopically expressing MLL fusions. Similarly, genetic disruption of menin / MLL fusion interaction by loss-of-function mutations abrogates the oncogenic properties of the MLL fusion proteins, blocks the development of leukemia in vivo and releases the differentiation block of MLL-transformed leukemic blasts. These studies also showed that menin is required for the maintenance of HOX gene expression by MLL fusion proteins. In addition, small molecule inhibitors of menin / MLL interaction have been developed suggesting druggability of this protein / protein interaction and have also demonstrated efficacy in preclinical models of AML. Together with the observation that menin is not a requisite cofactor of MLL1 during normal hematopoiesis, these data validate the disruption of menin / MLL interaction as a promising new therapeutic approach for the treatment of MLL rearranged leukemia and other cancers with an active HOX / MEIS1 gene signature. For example, an internal partial tandem duplication (PTD) within the 5’region of the MLL gene represents another major aberration that is found predominantly in de novo and secondary AML as well as myeloid dysplasia syndromes. Although the molecular mechanism and the biological function of MLL-PTD is not well understood, new therapeutic targeting strategies affecting the menin / MLL interaction might also prove effective in the treatment of MLL-PTD-related leukemias. Furthermore, castration-resistant prostate cancer has been shown to be dependent on the menin / MLL interaction. The gene expression profile observed for KMT2A amplification is similar to that seen for partial tandem duplicationMLL protein is also known as Histone-lysine N-methyltransferase 2A (KMT2A) protein in the scientific field (UniProt Accession #Q03164) .Relapsed / refractory (R / R) acute leukemia with alterations in KMT2A (also called MLL1; 9-15%of adult AML, 10%of ALL) or NPM1 (30%of adult AML) are often associated with poor outcomes. NPM1 denotes a gene encoding for the protein nucleophosmin (NPM) . NPMl mutations are described in the art and AML with the mutated NPM1 gene is a distinct subtype according the 2016 World Health Organization (WHO) classification.NUP98 and NUP214 genes have been identified in recurrent chromosomal translocations found in hematologic malignancies. NUP98-rearrangement has been shown in cell lines to be sensitive towards menin-KMT2A inhibition by VTP50469.WO2021121327 describes compounds useful as inhibitors targeting the menin-MLL interaction. WO2022262796 describes one such compound, (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide besylate salt and solvates thereof. These compounds may be useful for treating diseases such as cancer, including but not limited to leukemia, myelodysplastic syndrome (MDS) , and myeloproliferative neoplasms (MPN) ; and diabetes.Pre-clinical studies demonstrated the relevance of the menin-KMT2A protein-protein interaction in sustaining leukemic cells with KMT2A and NPM1 alterations. (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide or a pharmaceutically acceptable salt or solvate thereof, is a potent and selective inhibitor of the interaction between the scaffolding protein menin and the methyltransferase KMT2A with preclinical activity in KMT2A-or NPM1-altered leukemic cell lines.It is desirable to provide novel treatment regimens that involve such compounds for the treatment of cancer, in particular leukemias, more in particular relapsed / refractory acute leukemias harboring KMT2A, NPM1 alterations, nucleoporin 98 (NUP98) gene or nucleoporin 214 gene (NUP214) alterations.SUMMARY OF THE INVENTIONThe present invention is directed to methods of treating cancer and medical uses of a menin inhibitor compound for treating cancer, wherein the compound is administered in a dosage regime as described herein. The dosage regime may provide benefits in terms of efficacy and patient safety. Specifically, the dosage regime may provide benefits in terms of the reduction of incidence or severity of adverse events, such as differentiation syndrome, whilst also achieving therapeutic efficacy.The present invention provides a compound for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamideor a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamideor a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a method of treating cancer, the method comprising administering a compound to a subject in need thereof, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamideor a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a method of treating cancer, the method comprising administering a compound to a subject in need thereof, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamideor a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, 90-400mg, 100-380mg, 120-380mg, 180-320mg, 200-300mg, 200mg, 250 mg or 300mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.BRIEF DESCRIPTION OF THE DRAWINGSThe summary, as well as the following detailed description, is further understood when read in conjunction with the appended drawings. For the purpose of illustrating the invention, there are shown in the drawings exemplary embodiments of the invention; however, the invention is not limited to the specific disclosure of the drawings. In the drawings:Figure 1 is an X-ray powder diffraction (XRPD) pattern of a crystalline form A of (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide bis-besylate salt hydrate.Figure 2 is an X-ray powder diffraction (XRPD) pattern of intermediate 234b.Figure 3 shows the change in Steady-state (SS) (C2D1) Cmax upon dose escalation (October 2023) .Figure 3A shows the change in Steady-state (SS) (C2D1) Cmax upon dose escalation (July 2024) .Figure 4 shows the change in Steady-state (SS) (C2D1) AUCτ upon dose escalation (October 2023) .Figure 4A shows the change in Steady-state (SS) (C2D1) AUCτ upon dose escalation (July 2024) .Figure 5A shows changes in gene expression following treatment with the compound.Figure 5B shows changes in mutation burden following treatment with the compound.Figure 5C Gene expression (MEIS1) in bone marrow across selected cohorts at disease evaluation 1 (Disease evaluation 1 is the first time for assessment of response in bone marrow which occurs at cycle 2 day 1 + / -a couple of days)Figure 5D Percent change in expression of HOXA9 among R / R and ND participants in bone marrow before and after receiving the compound 100mg BID or 50mg BID in combination with VEN+AZA ( ‘DE’ means disease evaluation; ‘BM’ means bone marrow)Figure 5E Percentage of CD11b+ blasts in peripheral blood before and after receiving the compound 100 mg BID or 50 mg BID in combination with VEN+AZAFigure 5F Percentage of CD11b+ blasts in peripheral blood before and after receiving the compound 100 mg BID or 50 mg BID in combination with ‘7+3’Figure 5G NPM1 mutation burden reduction in bone marrow at first disease evaluation for participants receiving the compound 100 mg BID or 50 mg BID in combination with VEN+AZA. Number of patients at 50 mg dose level are 9 and Number of patients at 100 mg dose level are 9. Note: Not Detected values are presented as 0 in the graph. ( ‘SCRN’ means screening, ‘DE1’ means disease evaluation 1)Figure 6 shows the mean plasma concentration in dogs after the administration of a 30 mg dose of the compound.Figure 7 shows the change in bone marrow blasts after treatment with the compound (KMT2A (A) ; NPM1 (B) –October 2023 –linked to Example 12 Part A) .Figure 7A The percent best relative-change in bone marrow (BM) blasts from baseline in NPM1 and KMT2A-r participants (AML population) based on data cut-off July 2024 (linked to Example 12 Part B) .Figure 8 shows compound exposures on day 1 of cycle 1 across mono-and combination therapy (top: Cmax; bottom: AUC0-12) .Figure 8A shows compound exposures on day 1 of cycle 2 across mono-and combination therapy (top: Cmax; bottom: AUCτ) . (SS means Steady-state) (R / R refers to cohort A3; ND unfit refers to cohort B1; ND fit refers to cohort C1 –in this figure cohort A3 and cohort B1 are taken together (R / R_ND UNFIT)Figure 9 shows venetoclax exposures on day 4 in combination with increasing BID doses (15 mg BID, 30 mg BID, 50 mg BID) of the compound (top: DN Cmax; bottom: DN AUC0-24) .Figure 9A shows steady-state venetoclax exposures in combination with increasing doses of the compound (top: DN Cmax; bottom: DN AUC0-24) . (SS means Steady-state; DN means dose normalized)Figure 10 shows the Effect on Survival of Mice Bearing Disseminated NUP98-r CPCT-0021 AML. Tumor cells were implanted on Day 0 and treatment occurred on Days 44-84 for a total of 42 doses. Line underneath the X axis indicates the dosing period. Data are displayed to Day 196 when all remaining mice were removed from study. *Denotes significant difference (p≤0.05) in survival between treatment and vehicle control (n=7 / group) .Figure 11 shows the impact of increased drug load on tablet stability ( ‘SL’ means Shelf life Limiting)Figure 12A shows the percent best relative-change in bone marrow (BM) blasts from baseline in NPM1 and KMT2A-r participants (AML population) in selected Cohort A3 (at 50mg BID or 100mg BID target dose) based on data cut-off July 2024.Figure 12B shows the percent best relative-change in bone marrow (BM) blasts from baseline in NPM1 and KMT2A-r participants (AML population) in selected Cohort B1 (at 50mg BID or 100mg BID target dose) based on data cut-off July 2024.Figure 12C shows the percent best relative-change in bone marrow (BM) blasts from baseline in NPM1 and KMT2A-r participants (AML population) in selected Cohort C1 (at 50mg BID or 100mg BID target dose) based on data cut-off July 2024.DETAILED DESCRIPTION OF THE INVENTIONThe disclosure may be more fully appreciated by reference to the following description, including the following glossary of terms and the concluding examples. It is to be appreciated that certain features of the disclosed dosage forms, compositions and methods which are, for clarity, described herein in the context of separate aspects, may also be provided in combination in a single aspect. Conversely, various features of the disclosed dosage forms, compositions and methods that are, for brevity, described in the context of a single aspect, may also be provided separately or in any sub-combination.Some of the quantitative expressions given herein are not qualified with the term "about. " It is understood that whether the term "about" is used explicitly or not, every quantity given herein is meant to refer to the actual given value, and it is also meant to refer to the approximation to such given value that would reasonably be inferred based on the ordinary skill in the art, including approximations due to the experimental and / or measurement conditions for such given value.Throughout the description and claims of this specification, the words "comprise" and "contain" and variations of the words, for example "comprising" and "comprises" , mean "including but not limited to" , and are not intended to (and do not) exclude other components. As used herein, any instance of “comprising” may also include “consisting essentially of” and “consisting of” . For example, a composition described herein as “comprising” certain components can also to be taken as disclosure of a composition “consisting essentially of” and “consisting of” those components. References to a composition “consisting essentially of” particular elements are intended to mean a composition consisting of the particular elements and any unavoidable impurities, for example impurities not exceeding the impurity levels described herein.For the purposes of this disclosure, the terms "crystalline form" and "polymorph" are synonymous. Characterizing information for crystalline forms is provided herein. It should be understood that the determination of a particular form can be achieved using any portion of the characterizing information that one skilled in the art would recognize as sufficient for establishing the presence of a particular form. For example, even a single distinguishing peak can be sufficient for one skilled in the art to appreciate that a particular form is present.The term "isolated form" refers to a compound present in a form which is separate from any mixture with another compound (s) , solvent system or biological environment.The term “room temperature” (RT) refers to a temperature of from about 15 ℃ to about 30 ℃, in particular from about 20 ℃ to about 30 ℃. Preferably, room temperature is a temperature of about 25 ℃.When a crystalline form is identified using one or more XRPD peaks given as angles 2θ (two theta) , each of the 2θ values is understood to mean the given value ± 0.2 degrees two theta, unless otherwise expressed.The term “seeding” refers to the addition of crystalline material to a solution or mixture to initiate crystallisation or recrystallisation."Pharmaceutically acceptable" means approved or approvable by a regulatory agency of the Federal or a state government or the corresponding agency in countries other than the United States, or that is listed in the U.S. Pharmacopoeia or other generally recognized pharmacopoeia for use in animals, and more particularly, in humans.Pharmaceutically acceptable salts include acid addition salts and base addition salts. Such salts may be formed by conventional means, for example by reaction of a free acid or a free base form with one or more equivalents of an appropriate base or acid, optionally in a solvent, or in a medium in which the salt is insoluble, followed by removal of said solvent, or said medium, using standard techniques (e.g. in vacuo, by freeze-drying or by filtration) . Salts may also be prepared by exchanging a counter-ion of a compound described herein in the form of a salt with another counter-ion, for example using a suitable ion exchange resin.The pharmaceutically acceptable salts as mentioned hereinabove or hereinafter are meant to comprise the therapeutically active non-toxic acid salt forms which the compounds disclosed herein (such as (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide and solvates thereof) are able to form.Appropriate acids comprise, for example, inorganic acids such as hydrohalic acids, e.g. hydrochloric or hydrobromic acid, sulfuric, nitric, phosphoric and the like acids; or organic acids such as, for example, acetic, propanoic, hydroxyacetic, lactic, pyruvic, oxalic (i.e. ethanedioic) , malonic, succinic (i.e. butanedioic acid) , maleic, fumaric, malic, tartaric, citric, methanesulfonic, ethanesulfonic, benzenesulfonic, p-toluenesulfonic, cyclamic, salicylic, p-aminosalicylic, pamoic and the like acids. Conversely said salt forms can be converted by treatment with an appropriate base into the free base form.Reference to “a pharmaceutically acceptable salt or a solvate thereof” is intended to include any pharmaceutically acceptable salt and any solvate thereof, any subgroup thereof or any combination of pharmaceutically acceptable salts and solvates thereof. For example, reference to “a besylate salt of (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a solvate thereof” is intended to include any besylate salt and any solvate thereof, any subgroup thereof or any combination of besylate salts and solvates thereof.A skilled person will understand that (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide bis-besylate salt or a hydrate thereof, refers to the bis-besylate salt of (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, and also to the hydrates of the bis-besylate salt of (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide.A skilled person will appreciate that a “besylate salt” may also be referred to as a benzenesulfonate salt.(R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide or a pharmaceutically acceptable salt thereof may exist as a solvate. The term solvate comprises the solvent addition forms. Examples of such solvent addition forms are e.g. hydrates, alcoholates and the like. Thus, a “solvate” may be a solvate with water (i.e., a hydrate) or with a common organic solvent.In the context of the present invention, the “free base” form of the compound described herein means (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide. The compound described herein may be provided either in the free base form or as a salt or solvate thereof. The dosage of the compound or the amount of the compound in a composition may be expressed as being “calculated based on free base form” . Where the compound is provided as a salt or a solvate and the dosage or amount of the compound is expressed as being calculated based on the free base form, the dosage or amount of salt or solvate provided is the equivalent amount to provide the defined amount of free base. The mass of the salt or solvent that is equivalent to a given mass of the free base can be calculated according to the formula:mass (salt or solvate) = mass (free base) x conversion factorThe conversion factor can be calculated according to the formula:conversion factor = molecular mass (salt or solvate) / molecular mass (free base)For example, when reference is made to a dosage of 60 mg calculated based on the free base form, and the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide bis-besylate salt anhydrate (bis-BSA anhydrate) , the equivalent amount of bis-BSA anhydrate can be calculated as follows:conversion factor = molecular mass (bis-BSA anhydrate) / molecular mass (free base) = (599.80 + 2 x 158.17) / 599.80 = 1.527mass (bis-BSA anhydrate) = 60 mg x 1.527 = 91.620 mgThe loading (w / w) of the active pharmaceutical ingredient in a composition can be calculated based on the free base form as follows:loading = mass (free base) / mass (composition) x 100%References to “impurities” or any subgroup thereof, are intended to include any pharmaceutically acceptable salts and any solvates thereof, and any subgroup thereof or any combination of pharmaceutically acceptable salts and solvates thereof.The term "subject" refers to an animal, preferably a mammal, most preferably a human, who has been the object of treatment, observation or experiment.In an embodiment, the subject is human and is an adult (≥18 years of age) , or adolescent (≥12 and <18 years of age) .In an embodiment, the subject is a human adult (≥18 years of age) .In an embodiment, the subject is a human adolescent (≥12 and <18 years of age) .The term “therapeutically effective amount” as used herein means that amount of active compound or pharmaceutical agent that elicits the biological or medicinal response in a tissue system, animal or human that is being sought by a researcher, veterinarian, medicinal doctor or other clinician, which includes alleviation or reversal of the symptoms of the disease or disorder being treated. A therapeutic agent is an active compound or pharmaceutical agent that elicits the biological or medicinal response in a tissue system, animal or human that is being sought by a researcher, veterinarian, medicinal doctor or other clinician, which includes alleviation or reversal of the symptoms of the disease or disorder being treated. In an embodiment a therapeutic agent is dosed in a therapeutically effective amount.The term “composition” is intended to encompass a product comprising the specified ingredients in the specified amounts, as well as any product which results, directly or indirectly, from combinations of the specified ingredients in the specified amounts.The term “balance filler” when used herein in relation to a composition means that the rest of the composition (i.e. the balance) is made up of the filler. This term is not intended to exclude the presence of small amounts of unavoidable impurities, wherein “small amounts” means amounts that do not substantially affect the properties of the composition. For example, compositions described herein may comprise a total of less than 3%w / w (relative to the total weight of the composition) of impurities, such as less than 2.5%w / w, less than 2%w / w, less than 1.5%w / w, less than 1%w / w, or less than 0.5%w / w. As described herein, the compound may be a solvate or hydrate and / or may comprise unbound solvent (e.g. water) molecules. Any solvent (e.g. water) within the compound is therefore also not excluded. Accordingly, any composition described herein comprising the compound, recited excipients (e.g. glidant and lubricant) and balance filler, may also optionally comprise impurities, e.g. up to the amounts indicated herein, and solvent (e.g. water) as part of the compound. In some embodiments, a composition described herein comprising the compound, recited excipients (e.g. glidant and lubricant) and balance filler, may also optionally comprise impurities, e.g. up to the amounts indicated herein, and water as part of the compound."Granulation" as used herein refers to the process of binding particles of a dry powder composition through agglomeration to provide larger particles (granules) . Granulation includes wet granulation, which requires a liquid in the process, and dry granulation, which does not require any liquid.The "intragranular phase" of a tablet comprises those components of the tablet composition that are present within the granules. The "extragranular phase" of a tablet comprises the components that are added to the tablet composition after granule formation and before compression to provide the tablet.As used herein, unless otherwise noted, the term "affect" or "affected" (when referring to a disease, syndrome, condition or disorder that is affected by the inhibition of menin / MLL protein / protein interaction inhibitor) includes a reduction in the frequency and / or severity of one or more symptoms or manifestations of said disease, syndrome, condition or disorder; and / or includes the prevention of the development of one or more symptoms or manifestations of said disease, syndrome, condition or disorder or the development of the disease, condition, syndrome or disorder.The terms “treatment” and “treating, ” as used herein, are intended to refer to all processes wherein there may be a slowing, interrupting, arresting or stopping of the progression of a disorder, or amelioration of one or more symptoms thereof, but does not necessarily indicate a total elimination of all symptoms.The terms “administer” and “administration” have their usual and ordinary meaning in the art of treating a patient with a drug. It will be clear that the term “co-administration” and “co-administer” as used herein refer to administering two drugs to a patient in such a manner and with such timing that both drugs reside in the patient's body at the same time. The coadministration may be concurrently or sequentially in time, and the co-administered drugs may be administered to a patient at the same time, or separately but near in time, or on the same day, or otherwise in a way that results in substantial overlap of the residence periods for the respective drugs in the body.The term “adverse event” (AE) refers to any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non investigational) product. An AE does not necessarily have a causal relationship with the study treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal finding) , symptom, or disease temporally associated with the use of a medicinal (investigational or non investigational) product, whether or not related to that medicinal (investigational or non investigational) product. This includes any occurrence that is new in onset or aggravated in severity or frequency from the baseline condition, or abnormal results of diagnostic procedures, including laboratory test abnormalities.As used herein, “AUC” refers to the “area under the curve” , i.e. the area under the plasma concentration-time curve. The AUC is a measure of total systemic exposure to a drug. “AUCτ” refers to the AUC during a 12-hour dosing interval (τ) at steady state. “AUCinf” indicates the area under the plasma concentration-time curve extrapolated to infinity.As used herein, “Cmax” refers to the maximum concentration of a drug in blood, cerebrospinal fluid, or target organ after a drug has been administered. “Tmax” refers to the time of maximum concentration.When used in the context of statistics, “SD” refers to standard deviation, which is a measure of the amount of variation or dispersion of a set of values.Where any aspects or embodiments of the invention are referred to as comprising particular elements and / or features, it is contemplated that these aspects or embodiments of the invention may also consist, or consist essentially of, such elements and / or features.Methods of treatment and medical usesAs described in WO2021121327 and WO2022262796 (which are incorporated herein by reference in their entirety) , it has been found that the compound described herein blocks the interaction of menin with MLL proteins and oncogenic MLL fusion proteins. (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide is a menin / MLL inhibitor that may be used in the treatment of cancer.Cancers that may benefit from a treatment with the compound (including combinations thereof) described herein comprise leukemias, lymphomas, myelomas or solid tumor cancers (e.g. prostate cancer, lung cancer, breast cancer, pancreatic cancer, colon cancer, liver cancer, melanoma and glioblastoma, etc. ) . In some embodiments, the leukemias include acute leukemias, chronic leukemias, myeloid leukemias, myelogeneous leukemias, lymphoblastic leukemias, lymphocytic leukemias, Acute myelogeneous leukemias (AML) , Chronic myelogenous leukemias (CML) , Acute lymphoblastic leukemias (ALL) , Chronic lymphocytic leukemias (CLL) , T cell prolymphocytic leukemias (T-PLL) , Large granular lymphocytic leukemia, Hairy cell leukemia (HCL) , MLL-rearranged leukemias, MLL-PTD leukemias, MLL amplified leukemias, MLL-positive leukemias, leukemias exhibiting HOX / MEIS1 gene expression signatures etc.The cancer may be selected from myelodysplastic syndrome (MDS) and myeloproliferative neoplasms (MPN) .The cancer may be leukemia. The leukemia may be an acute leukemia. The leukemia may be selected from acute leukemias, chronic leukemias, myeloid leukemias, myelogeneous leukemias, lymphoblastic leukemias, lymphocytic leukemias, Acute myelogeneous leukemias (AML) , Chronic myelogenous leukemias (CML) , Acute lymphoblastic leukemias (ALL) , Chronic lymphocytic leukemias (CLL) , T cell prolymphocytic leukemias (T-PLL) , Large granular lymphocytic leukemia, Hairy cell leukemia (HCL) , MLL-rearranged leukemias, MLL-PTD leukemias, MLL amplified leukemias, MLL-positive leukemias, and leukemias exhibiting HOX / MEIS1 gene expression signatures. The acute leukemia may be mixed-phenotype acute leukemia (MPAL) .The leukemia may be selected from MLL-rearranged leukemias, in particular MLL-rearranged AML or ALL. The leukemia may be selected from leukemias with MLL gene alterations, in particular AML or ALL with MLL gene alterations. A gene alteration refers to any change in the sequence of a gene. Gene alterations include, for example, gene rearrangements (also referred to as translocations) , amplifications, partial tandem duplications (PTD) , insertions and deletions. Gene alterations may also be referred to as mutations ( ‘alteration’ and ‘mutation’ are used interchangeably herein) . The leukemia may be AML harboring KMT2A gene rearrangements or NPM1 mutations. The leukemia may be newly diagnosed AML harboring KMT2A gene rearrangements or NPM1 mutations. The leukemia may be AML harboring KMT2A gene rearrangements and / or NPM1 mutations. The leukemia may be newly diagnosed AML harboring KMT2A gene rearrangements and / or NPM1 mutations. The leukemia may be extramedullary AML (EM AML) . EM AML is characterized by the presence of leukemic cells in organs or tissues outside of the blood or bone marrow. The leukemia may be EM AML with KMT2A rearrangements. The leukemia may be cutaneous EM AML. The leukemia may be cutaneous EM AML with KMT2A rearrangements.The leukemia may be AML or ALL. The leukemia may be AML. The leukemia may be ALL. The leukemia may be refractory / relapsed acute leukemia. The leukemia may be refractory / relapsed acute leukemia with prior venetoclax exposure and / or prior allogeneic transplant. The leukemia may be a leukemia having a NPM1 mutation, e.g. a NPM1c mutation. The NPM1 mutation may one or more of a frameshift, an insertion or a translocation. In particular, the leukemia may be abstract NPM1-mutated AML. The leukemia may be a leukemia having a KMT2A alteration. The KMT2A alteration may comprise one or more of a KMT2A rearrangement (also referred to as a translocation) , amplification or partial tandem duplication. The leukemia may be a leukemia having a nucleoporin 98 (NUP98) gene or nucleoporin 214 gene (NUP214) alteration. The leukemia may be a leukemia having a nucleoporin 98 (NUP98) gene alteration. The leukemia may be a leukemia having a nucleoporin 214 gene (NUP214) alteration. The leukemia may be an acute leukemia having a nucleoporin 98 (NUP98) gene or nucleoporin 214 gene (NUP214) alteration. The leukemia may be an acute leukemia having a nucleoporin 98 (NUP98) gene alteration. The leukemia may be an acute leukemia having a nucleoporin 214 gene (NUP214) alteration.The leukemia may be AML with a NPM1 mutation wherein the NPM1 mutation is an insertion a frameshift or a translocation.The leukemia may be AML or ALL, each with a KMT2A mutation wherein the KMT2A mutation is a translocation, amplification or partial tandem duplication.The leukemia may be AML with a nucleoporin 98 (NUP98) gene or nucleoporin 214 gene (NUP214) alteration. The leukemia may be AML with a nucleoporin 98 (NUP98) gene alteration. The leukemia may be AML with a nucleoporin 214 gene (NUP214) alteration.The leukemia may be AML with a NPM1 mutation wherein the NPM1 mutation is an insertion / frameshift or translocation, or AML or ALL, each with a KMT2A mutation wherein the KMT2A mutation is a translocation, amplification or partial tandem duplication.The leukemia, or any subgroup thereof, may be a leukemia having one or more co-mutations. The one or more co-mutations may be selected from FLT3, DNMT3A, NRAS, TP53, KRAS, TET2, IDH2, and IDH1 mutations. The one or more co-mutations may be selected from FLT3, DNMT3A, NRAS, TP53, KRAS, TET2, IDH2, IDH1, WT1, ASXL1, SRSF2, PPM1D, MEN1 and RAD21 mutations. The co-mutation may be a FLT3 (FLT-3) mutation. In particular the leukemia is AML with NPM1 mutations and a FLT3 co-mutation. In particular the leukemia is AML with KMT2A rearrangements and a FLT3 co-mutation.The cancer may be a hematological cancer in a subject exhibiting NPM1 gene mutations and / or mixed lineage leukemia gene (MLL; MLL1; KMT2A) alterations, mixed lineage leukemia (MLL) , MLL-related leukemia, MLL-associated leukemia, MLL-positive leukemia, MLL-induced leukemia, rearranged mixed lineage leukemia, leukemia associated with a MLL, rearrangement / alteration or a rearrangement / alteration of the MLL gene, acute leukemia, chronic leukemia, myelodysplastic syndrome (MDS) , and myeloproliferative neoplasms (MPN) . The leukemia may be an acute leukemia harboring KMT2A and / or NPM1 gene alterations. The leukemia may be AML harboring KMT2A and / or NPM1 gene alterations. The leukemia may be an acute leukemia harboring KMT2A and / or NPM1 gene alterations and / or nucleoporin 98 (NUP98) gene alterations and / or nucleoporin 214 gene (NUP214) alterations. The leukemia may be AML harboring KMT2A and / or NPM1 gene alterations and / or nucleoporin 98 (NUP98) gene alterations and / or nucleoporin 214 gene (NUP214) alterations.Patients with AML harboring KMT2A alterations (10%of children and 15%of adults with AML) or NPM1 mutations (8%of children and 30%of adults with AML) and patients with KMT2A-r ALL have particularly aggressive disease with poor outcomes and in the relapsed / refractory setting. These patients represent a high unmet medical need, necessitating the development of new therapies.It will be clear that each of the specific leukemias described herein may be refractory / relapsed, for example relapsed / refractory acute leukemia harboring KMT2A and / or NPM1 gene alterations, for example relapsed / refractory AML harboring KMT2A and / or NPM1 gene alterations, for example relapsed / refractory acute leukemia harboring KMT2A and / or NPM1 gene alterations and / or nucleoporin 98 (NUP98) gene alterations and / or nucleoporin 214 gene (NUP214) alterations, for example relapsed / refractory AML harboring KMT2A and / or NPM1 gene alterations and / or nucleoporin 98 (NUP98) gene alterations and / or nucleoporin 214 gene (NUP214) alterations.The cancer may be relapsed / refractory or newly diagnosed AML with NPM1, KMT2A, NUP98 or NUP214 gene alterations. The cancer in particular is relapsed / refractory AML with NPM1, KMT2A, NUP98 or NUP214 gene alterations. The cancer in particular is newly diagnosed AML with NPM1, KMT2A, NUP98 or NUP214 gene alterations gene alterations.The cancer may be relapsed / refractory or newly diagnosed AML with NPM1, KMT2A or NUP98 gene alterations. The cancer in particular is relapsed / refractory AML with NPM1, KMT2A or NUP98 gene alterations. The cancer in particular is newly diagnosed AML with NPM1, KMT2A or NUP98 gene alterations.In the embodiments (including clauses) herein, any of the refractory / relapsed acute leukemias (e.g. AML) may be with prior venetoclax exposure and / or prior allogeneic transplant. In the embodiments (including clauses) herein, any of the refractory / relapsed acute leukemias (e.g. AML) may be with prior venetoclax exposure and / or prior allogeneic transplant.In any of the embodiments (including clauses) herein, any of the relapsed / refractory acute leukemias (e.g. AML) may be with prior menin-KMT2A inhibitor exposure.In any of the embodiments (including clauses) herein, the leukemia may be relapsed / refractory AML with KMT2A rearrangements and / or NPM1 mutations and with prior menin-KMT2A inhibitor exposure.In an embodiment, relapsed AML is defined as bone marrow blast burden ≥5%after having initially achieved CR, CRh, or CRi following at least one cycle of initial therapy that was administered with intent to induce remission.In an embodiment, refractory AML is defined as bone marrow blast burden ≥5%with never having achieved CR, CRh, or Cri; patients must have received at least two cycles of initial therapy that was administered with intent to induce remission per Investigator’s assessment.In an embodiment the subject, to which the compound was administered according to any of the embodiments described herein, has a CR with MRD negativity. In an embodiment the subject, to which the compound was administered according to any of the embodiments described herein, has a CR / CRh / CRi with MRD negativity.In an embodiment the subject, to which the compound was administered according to any of the embodiments described herein, has a CR with MRD negativity. In an embodiment the subject, to which the compound was administered according to any of the embodiments described herein, has a CR / CRh / CRi with MRD negativity.The compound for use of any of the embodiments or clauses described herein, wherein the dosage regimen is a dosage regimen that provides CR with MRD negativity.The compound for use of any of the embodiments or clauses described herein, wherein the dosage regimen is a dosage regimen that provides CR / CRh / CRi with MRD negativity.In an embodiment, the minimal cutoff for MRD negativity will be <1 blast per 1000 leukocytes (MRD level <10-3) . In an embodiment, the cutoff for MRD negativity is <1 blast per 10000 leukocytes. MRD negativity can be assessed by flow cytometry (MRD level <10-3) , or for molecular MRD, a digital PCR-based assay or similar technology will have a limit of detection of at least <10-3 (for example sensitivity ≥10-4) .In an embodiment the subject, to which the compound was administered according to any of the embodiments described herein, has transfusion independence.The compound for use of any of the embodiments or clauses described herein, wherein the dosage regimen is a dosage regimen that provides transfusion independence.The cancers, leukemias, or any subgroup thereof as described herein, may optionally have a FLT3 (FLT-3) co-mutation.In an embodiment, DS management comprises more frequent hemodynamic monitoring and / or prophylaxis with hydroxyurea and / or corticosteroids.It will be clear that the cancer may be any one of the specific hematological cancers described herein. It will be clear that the cancer may be any one of the specific leukemias described herein.In an embodiment, the subject complies with the inclusion criteria as described herein. In an embodiment, the subject complies with the exclusion criteria as described herein. In an embodiment, the subject complies with one or more of the inclusion criteria as described herein. In an embodiment, the subject complies with one or more of the exclusion criteria as described herein.Acute Myeloid Leukemia (AML)AML is a heterogeneous disease characterized by uncontrolled clonal expansion of hematopoietic progenitor cells (myeloid blasts) in the peripheral blood, bone marrow, and other tissues. AML is the second most common form of leukemia in adults, with a global incidence of 3.7 per 100,000 persons. In approximately 15%of AML cases, chromosomal alterations (including rearrangement, PTD, or translocation) involving the gene KMT2A; also known as MLL1, occur and result in oncogenic fusion proteins that drive particularly aggressive leukemias.Mutation in NPM1 constitutes approximately 30%of AML and is the second most common mutation in AML. In relapsed or refractory AML, prognosis is poor with mutated NPM1, highlighting an unmet clinical need. Coexistence of the co-occurring FLT3-ITD-DNMT3A mutation and NPM1 mutation define the most unfavorable category of NPM1 mutated AMLs, with an OS rate of <50%, emphasizing the need for new therapies. Studies have revealed the importance of the menin-KMT2A interaction in patients with KMT2A and NPM1 mutations.Acute Lymphoblastic Leukemia (ALL)ALL is a hematologic malignancy propagated by impaired differentiation, proliferation, and accumulation of lymphoid progenitor cells in the bone marrow and / or extramedullary sites. ALL represents 12%of all leukemia cases, and represents about 20%of adult leukemias.Risk assessment and stratification in ALL depends on a comprehensive cytogenetic and molecular evaluation, particularly since recurrent chromosomal and molecular abnormalities are crucial for prognostication and treatment decisions. Rearrangements of the KMT2A gene are found in 10%and 5%of adult and pediatric ALL cases, respectively. KMT2A-r ALL is characterized by hyperleukocytosis, aggressive behavior with early relapse, relatively high incidence of CNS involvement, and poor prognosis.Dosage RegimensDescribed herein is a compound for use in a method of treating cancer.All statements including the expression “for use in a method of treating cancer” should also be considered to be included herein with the expression “for use in a method of treating cancer” being replaced by the expression “for use in treating cancer” .Also described herein is a method of treating cancer, the method comprising administering a compound to a subject in need thereof.The compound is bleximenib which is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamideor a pharmaceutically acceptable salt or solvate thereof. The compound is administered to a subject in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound. The dosage regimen may comprise administering the compound at a daily dosage lower than the target dosage prior to the target dosage period. It will be clear that in some embodiments the compound may be administered at a target dosage level and target daily dosage without a prior lower daily dosage (no initial daily dosage and step-up daily dosage) . It will thus be clear that the “daily dosage lower than the target dosage prior to the target dosage period” , refers to the initial dosage period and optionally the step-up daily dosage period if present) .In an embodiment, the present invention provides a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.In some embodiments, the target dosage period starts at least 5 days after the start of the dosage regimen, at least 7 days after the start of the dosage regimen, 7 to 56 days after the start of the dosage regimen, 7 to 28 days after the start of the dosage regimen, 7 to 21 days after the start of the dosage regimen or 7 to 14 days after the start of the dosage regimen.In an embodiment the dosage regime comprises: (i) an initial dosage period wherein the compound is administered at an initial daily dosage; (ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and (iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present; wherein all daily dosages are calculated based on the free base form of the compound.In some embodiments, the target daily dosage is 90-400mg, 100-380mg, 120-380mg, 180-320mg or 200-300mg. In some embodiments, the target daily dosage is 140-180mg, 120-200mg, 180-220mg, 160-240mg, 180-320mg, 280-320mg, 260-340mg or 180-340mg. In some embodiments, the target daily dosage is 200-400mg. The target daily dosage may be 120mg or 180mg. Preferably, the target daily dosage is 200mg, 260 mg, 300mg or 400mg. Preferably, the target daily dosage is provided by twice daily (BID) dosing. The target daily dosage may be provided by dosing at 30-200mg BID, 45-200mg BID, 50-190mg BID or 60-190mg BID. The target daily dosage may be provided by dosing at 100-200mg BID, preferably 100-150 mg BID. The target daily dosage may be provided by dosing at 70-90mg BID, 60-100mg BID, 90-110mg BID, 80-120mg BID, 90-160mg BID, 140-160mg BID, 130-170mg BID, 90-170mg BID. The target daily dosage may be provided by dosing at 60mg, 90mg, 100mg, 130mg, 150mg BID or 200mg BID. Preferably, the target daily dosage is provided by dosing at 100mg BID or 150mg BID. The target daily dosage may be at least twice the initial daily dosage.In some embodiments, the initial daily dosage is 30-120mg, 40-120mg, 50-110mg or 60-100mg. The initial daily dosage may be 30mg, 60mg, 90mg or 100mg. Preferably, the initial daily dosage is provided by twice daily (BID) dosing. The initial daily dosage may be provided by dosing at 15-60mg BID, 20-60mg BID, or 25-55mg BID. The initial daily dosage may be provided by dosing at 15mg, 30mg, 45mg or 50mg BID.In some embodiments, the step-up daily dosage, where present, is 60-240mg, 80-240mg, 100-220mg or 120-200mg. The step-up daily dosage, where present, is 60mg, 120mg, 180mg or 200mg. Preferably, the step-up daily dosage, where present, is provided by twice daily (BID) dosing. The step-up daily dosage, where present, may be provided by dosing at 30-120mg BID, 40-120mg BID, 50-110mg BID, or 60-100 mg BID. The step-up daily dosage, where present, may provided by dosing at 30mg, 60mg, 90mg or 100mg BID.In some embodiments, the dosage regimen comprises: (i) an initial dosage period wherein the compound is administered at an initial daily dosage of 60-100mg provided by twice daily (BID) dosing of 30-50mg BID; (ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is 120-200mg provided by twice daily (BID) dosing of 60-100mg BID; and (iii) atarget dosage period wherein the compound is administered at a target daily dosage of 120-300mg provided by twice daily (BID) dosing of 60-150mg BID, wherein the target dosage level is greater than the step-up daily dosage, where present.In some embodiments, the dosage regimen comprises: (i) an initial dosage period wherein the compound is administered at an initial daily dosage of 60-100mg provided by twice daily (BID) dosing of 30-50mg BID; (ii) a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is 120-200mg provided by twice daily (BID) dosing of 60-100mg BID; and (iii) a target dosage period wherein the compound is administered at a target daily dosage of 120-300mg provided by twice daily (BID) dosing of 60-150mg BID, wherein the target dosage level is greater than the step-up daily dosage, where present.In some embodiments, the dosage regimen comprises: (i) an initial dosage period wherein the compound is administered at an initial daily dosage of 100mg provided by twice daily (BID) dosing of 50mg BID; (ii) a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is 200mg provided by twice daily (BID) dosing of 100mg BID; and (iii) a target dosage period wherein the compound is administered at a target daily dosage of 300mg provided by twice daily (BID) dosing of 150mg BID.In some embodiments, the dosage regimen comprises: (i) an initial dosage period wherein the compound is administered at an initial daily dosage of 100mg provided by twice daily (BID) dosing of 50mg BID; (ii) a target dosage period wherein the compound is administered at a target daily dosage of 200mg provided by twice daily (BID) dosing of 100mg BID.An embodiment relates to a compound for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamideor a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising(i) an initial dosage period of 14 days wherein the compound is administered at an initial daily dosage of 100mg provided by twice daily (BID) dosing of 50mg BID;(ii) a target dosage period wherein the compound is administered at a target daily dosage of 200mg provided by twice daily (BID) dosing of 100mg BID.An embodiment relates to a compound for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising(i) an initial dosage period of 14 days wherein the compound is administered at an initial daily dosage of 100mg provided by twice daily (BID) dosing of 50mg BID;(ii) a target dosage period wherein the compound is administered at a target daily dosage of 300mg provided by twice daily (BID) dosing of 150mg BID.An embodiment relates to a compound for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 300mg provided by twice daily (BID) dosing of 150mg BID.In some embodiments, the dosage regimen comprises: a target dosage period wherein the compound is administered at a target daily dosage of 400mg provided by twice daily (BID) dosing of 200mg BID.In some embodiments, the dosage regimen comprises: (i) an initial dosage period wherein the compound is administered at an initial daily dosage of 60-100mg provided by twice daily (BID) dosing of 30-50mg BID; (ii) a target dosage period wherein the compound is administered at a target daily dosage of 120-300mg provided by twice daily (BID) dosing of 60-150mg BID.In an embodiment, in adolescent human subjects, the compound is administered at a target daily dosage of 60mg provided by twice daily (BID) dosing of 30mg BID.It will be appreciated that the initial, step-up and target dosages described herein may be present in combination. In any of the dosage regimens described herein including an initial dosage period, the initial dosage period may be a period of at least 5 days, preferably at least 7 days. The initial dosage period may be a period of no more than 56 days. no more than 28 days or no more than 21 days. The initial dosage period may be a period of 7 to 28 days or 7 to 14 days, preferably 7 days, 14 days or 28 days. The step-up dosage period, when present, may be a period of at least 5 days, preferably at least 7 days. The step-up dosage period, when present, may be a period of no more than 28 days or no more than 21 days. The step-up dosage period, when present, may be a period of 7-14 days, preferably 7 days or 14 days. Preferably, the total duration of the initial dosage period and the step-up dosage period, when present, is 14 to 56 days, preferably 14 to 28 days. Preferably, the total duration of the initial dosage period and the step-up dosage period, when present, is 14 or 28 days (for example a 7 day initial dosage period and a 7 day step-up dosage period, a 14 day initial dosage period and no step-up dosage period, a 14 day initial dosage period and a 14 day step-up dosage period, or a 28 day initial dosage period and no step-up dosage period) .In some embodiments, after the target dosage period the compound is administered at a daily dosage lower than the target daily dosage, i.e. the dosage regimen comprises a reduced dosage period after the target dosage period. The target dosage period may be a period of at least 7 days, preferably at least 14 days, more preferably at least 28 days.It will be appreciated that any dosing described herein may be provided by a single dosage form (e.g. a single tablet or capsule) or multiple dosage forms (e.g. two or more tablets or capsules taken together to make up the required dosage amount) .In some embodiments, the dosage regimen is selected to provide a predetermined AUCτ in the subject at a time point at which steady state exposure to the target dosage is established. Accordingly, the dosage regiment may provide an AUCτ of at least 800 ng*h / mL in the subject following 14 days of dosing at the target daily dosage, wherein τ represents a 12 hour period after dosing. The dosage regimen may provide an AUCτ of 500 to 50000 ng*h / mL, 800 to 30000 ng*h / mL, 800 to 25000 ng*h / mL or 800 to 20000 ng*h / mL in the subject following 14 days of dosing at the target daily dosage, wherein τ represents a 12 hour period after dosing. The dosage regimen may provide an AUCτof at least 1000 ng*h / mL, at least 5000 ng*h / mL, or at least 8000 ng*h / mL in the subject following 14 days of dosing at the target daily dosage, wherein τ represents a 12 hour period after dosing, The dosage regimen may provide an AUCτ of 1000 to 30000 ng*h / mL, 1000 to 25000 ng*h / mL, 1000 to 20000 ng*h / m, 5000 to 30000 ng*h / mL, 5000 to 25000 ng*h / mL, 5000 to 20000 ng*h / mL, 8000 to 30000 ng*h / mL, 8000 to 25000 ng*h / mL or 8000 to 20000 ng*h / mL. The AUCτ value may be for a 12 hour period after dosing in a BID dosing regimen.In some embodiments, the dosage regimen is selected to provide a predetermined AUCτ in the subject at a time point at which steady state exposure to the target dosage is established. Accordingly, the dosage regiment may provide an AUCτ of at least 800 ng*h / mL in the subject following 29 days (cycle 2 day 1) of dosing at the target daily dosage, wherein τ represents a 12 hour period after dosing. The dosage regimen may provide an AUCτ of 500 to 50000 ng*h / mL, 800 to 30000 ng*h / mL, 800 to 25000 ng*h / mL or 800 to 20000 ng*h / mL in the subject following 29 days (cycle 2 day 1) of dosing at the target daily dosage, wherein τ represents a 12 hour period after dosing. The dosage regimen may provide an AUCτ of at least 1000 ng*h / mL, at least 5000 ng*h / mL, or at least 8000 ng*h / mL in the subject following 29 days (cycle 2 day 1) of dosing at the target daily dosage, wherein τ represents a 12 hour period after dosing, The dosage regimen may provide an AUCτ of 1000 to 30000 ng*h / mL, 1000 to 25000 ng*h / mL, 1000 to 20000 ng*h / m, 5000 to 30000 ng*h / mL, 5000 to 25000 ng*h / mL, 5000 to 20000 ng*h / mL, 8000 to 30000 ng*h / mL, 8000 to 25000 ng*h / mL or 8000 to 20000 ng*h / mL. The AUCτ value may be for a 12 hour period after dosing in a BID dosing regimen.In some embodiments, the dosage regimen is selected to provide a predetermined Cmax in the subject at a time point at which steady state exposure to the target dosage is established. Accordingly, the dosage regimen provides a Cmax of at least 100 ng / mL, at least 200 ng / mL, at least 500 ng / mL or at least 1000 ng / mL in the subject following 14 days of dosing at the target daily dosage. The dosage regimen may provide a Cmax of 100 to 5000 ng / mL, 100 to 4000 ng / mL, 200 to 5000 ng / mL, 200 to 4000 ng / mL, 500 to 5000 ng / mL, 500 to 4000 ng / mL, 1000 to 5000 ng / mL or 1000 to 4000 ng / mL in the subject following 14 days of dosing at the target daily dosage.In some embodiments, the dosage regimen is selected to provide a predetermined Cmax in the subject at a time point at which steady state exposure to the target dosage is established. Accordingly, the dosage regimen provides a Cmax of at least 100 ng / mL, at least 200 ng / mL, at least 500 ng / mL or at least 1000 ng / mL in the subject following 29 days (cycle 2 day 1) at the target daily dosage. The dosage regimen may provide a Cmax of 100 to 5000 ng / mL, 100 to 4000 ng / mL, 200 to 5000 ng / mL, 200 to 4000 ng / mL, 500 to 5000 ng / mL, 500 to 4000 ng / mL, 1000 to 5000 ng / mL or 1000 to 4000 ng / mL in the subject following 29 days (cycle 2 day 1) of dosing at the target daily dosage.In some embodiments, the dosage regimen is a dosage regimen that provides an overall response rate of at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%or at least 95%in a population of subjects receiving treatment according to the dosage regimen. The overall response rate may be 30%to 100%, 30%to 75%, 35 to 100%, 35 to 75%, 40 to 100%, 40 to 75%, 45 to 100%or 45 to 75%, 50 to 100%, 50 to 75%, 55 to 100%, 55 to 75%, 60 to 100%, 60 to 75%, 60 to 95%, 70 to 95%, 80 to 95%, 60 to 100%, 70 to 100%or 80 to 100%.In some embodiments, the dosage regimen is a dosage regimen that provides a CR / CRh rate of at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%or at least 85%in a population of subjects receiving treatment according to the dosage regimen. The CR / CRh rate may be 15%to 100%, 20%to 100%, 25%to 100%, 15%to 75%, 20 to 75%, 25 to 75%, 20 to 40%.In some embodiments, the dosage regimen is a dosage regimen that provides a transfusion independency rate of at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, or at least 75%in a population of subjects receiving treatment according to the dosage regimen.In some embodiments, the HSCT rate may be 10%to 90%, 10%to 50%, 10 to 30%, 20%to 90%, 20%to 50%, 20 to 30%, 15 to 75%, 15 to 50%, 20 to 75%, 20 to 70%or 15 to 40%in a population of subjects receiving treatment according to the dosage regimen. . In some embodiments, the HSCT rate may be at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%or at least 85%in a population of subjects receiving treatment according to the dosage regimen. In some embodiments, the HSCT rate may be about 15%, about 20%, about 25%, about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%or about 85%in a population of subjects receiving treatment according to the dosage regimen.In some embodiments, the dosage regimen is a dosage regimen administering the compound as a monotherapy that provides a CR / CRh rate of at least 20%, at least 25%, at least 30%, at least 35%, at least 40%or at least 45%in a population of subjects having relapsed / refractory AML with KMT2A rearrangements receiving treatment according the dosage regimen.In some embodiments, the dosage regimen is a dosage regimen administering the compound as a monotherapy that provides a CR / CRh rate of at least 20%, at least 25%, at least 30%, at least 35%, at least 40%or at least 45%in a population of subjects having relapsed / refractory AML with NPM1 mutations receiving treatment according to the dosage regimen.In some embodiments, the dosage regimen is a dosage regimen that provides a partial response or greater in a subject.In some embodiments, the dosage regimen is a dosage regimen that provides CR / CRh or greater in a subject.The response provided by the dosage regiment may be assessed in accordance with the criteria set out in any of Tables 1-3.In some embodiments, the duration of treatment is at least 4 weeks, at least 8 weeks, at least 12 weeks, at least 24 weeks or at least 48 weeks. The duration of treatment may be 4 to 144 weeks, 4 to 96 weeks, 8 to 144 weeks, 8 to 96 weeks, 12 to 144 weeks, 12 to 96 weeks, 24 to 144 weeks, 24 to 96 weeks, 48 to 144 weeks or 48 to 96 weeks.In some embodiments, the median duration of response in a population of subjects receiving treatment according to the dosage regimen is at least 12 weeks, at least 16 weeks, at least 24 weeks, at least 28 weeks, at least 32 weeks, at least 36 weeks, at least 40 weeks, at least 44 weeks, or at least 48 weeks. Response may be taken to be partial response or greater. The median duration of response may be 12 weeks to 144 weeks, 12 weeks to 96 weeks, 12 weeks to 48 weeks, 16 to 144 weeks, 16 to 96 weeks, 16 to 48 weeks, 24 to 144 weeks, 24 to 96 weeks or 24 to 48 weeks.In some embodiments, the dosage regimen is a dosage regimen administering the compound as a monotherapy and the median duration of response in a population of subjects having relapsed / refractory AML with KMT2A rearrangements receiving treatment according to the dosage regimen is at least 20 weeks, at least 24 weeks, at least 28 weeks, at least 32 weeks, at least 36 weeks, at least 40 weeks, at least 44 weeks, or at least 48 weeks.In some embodiments, the dosage regimen is a dosage regimen administering the compound as a monotherapy and the median duration of response in a population of subjects having relapsed / refractory AML with NPM1 mutations receiving treatment according to the dosage regimen is at least 20 weeks, at least 24 weeks, at least 28 weeks, at least 32 weeks, at least 36 weeks, at least 40 weeks, at least 44 weeks, or at least 48 weeks.In some embodiments, the dosage regimen is a dosage regimen administering the compound as a monotherapy and the median duration of CR / CRh in a population of subjects having relapsed / refractory AML with KMT2A rearrangements receiving treatment according to the dosage regimen is at least 20 weeks, at least 24 weeks, at least 28 weeks, at least 32 weeks, at least 36 weeks, at least 40 weeks, at least 44 weeks or at least 48 weeks.In some embodiments, the dosage regimen is a dosage regimen administering the compound as a monotherapy and the median duration of CR / CRh in a population of subjects having relapsed / refractory AML with NPM1 mutations receiving treatment according to the dosage regimen is at least 20 weeks, at least 24 weeks, at least 28 weeks, at least 32 weeks, at least 36 weeks, at least 40 weeks, at least 44 weeks, or at least 48 weeks.In some embodiments, the median time to response in a population of subjects receiving treatment according to the dosage regimen is 1.84 months. In some embodiments, the median time to response is between 0.9 –3.3 months. In some embodiments, the median time to response is <3 months. In some embodiments, the median time to response is <2 months. In some embodiments, the median time to response is <1 month.In some embodiments, the median time to CR / CRh in a population of subjects receiving treatment according to the dosage regimen is 1.84 months. In some embodiments, the median time to CR / CRh is between 0.9 –3.3 months. In some embodiments, the median time to CR / CRh is <3 months. In some embodiments, the median time to CR / CRh is <2 months. In some embodiments, the median time to CR / CRh is <1 month.In some embodiments, the median event-free survival in a population of subjects receiving treatment according to the dosage regimen is at least 4 weeks, at least 8 weeks, at least 12 weeks, at least 16 weeks or at least 24 weeks. The median event-free survival may be 8 weeks to 144 weeks, 12 weeks to 144 weeks, 12 weeks to 96 weeks, 12 weeks to 48 weeks, 16 to 144 weeks, 16 to 96 weeks, 16 to 48 weeks, 24 to 144 weeks, 24 to 96 weeks or 24 to 48 weeks.In some embodiments, the compound is for use in combination with cytarabine plus daunorubicin or idarubicin (7+3 Regimen) , and the median event-free survival in a population of subjects having newly diagnosed AML who are eligible for intensive chemotherapy and receiving treatment according to the dosage regimen, is at least 18 months, at least 20 months, at least 21 months, at least 23 months, at least 25 months or at least 30 months.In some embodiments, the compound is for use in combination with azacytidine and venetoclax, and the median event-free survival in a population of subjects having newly diagnosed AML who are ineligible for intensive chemotherapy and receiving treatment according to the dosage regimen, is at least 18 months, at least 20 months, at least 21 months, at least 23 months, at least 25 months or at least 30 months.In some embodiments, the overall survival in a population of subjects receiving treatment according to the dosage regimen is at least 4 weeks, at least 8 weeks, at least 12 weeks, at least 16 weeks or at least 24 weeks. The overall survival may be 8 weeks to 144 weeks, 12 weeks to 144 weeks, 12 weeks to 96 weeks, 12 weeks to 48 weeks, 16 to 144 weeks, 16 to 96 weeks, 16 to 48 weeks, 24 to 144 weeks, 24 to 96 weeks or 24 to 48 weeks.In some embodiments, the minimum residual disease negativity among subjects receiving treatment according to the dosage regimen and achieving CR / CRh / Cri, is at least 20%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%or at least 80%. The minimum residual disease negativity among subjects achieving CR / CRh / CRi may be 20%to 100%, 30%to 100%, 20%to 75%, 30%to 75%, 35 to 100%, 35 to 75%. 40 to 100%, 40 to 75%, 45 to 100%or 45 to 75%, 50 to 100%, 50 to 75%, 55 to 100%, 55 to 75%, 60 to 100%or 60 to 75%.In some embodiments, the minimum residual disease negativity among subjects receiving treatment according to the dosage regimen and achieving CR / CRh, is at least 20%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%or at least 80%. The minimum residual disease negativity among subjects achieving CR / CRh may be 20%to 100%, 30%to 100%, 20%to 75%, 30%to 75%, 35 to 100%, 35 to 75%. 40 to 100%, 40 to 75%, 45 to 100%or 45 to 75%, 50 to 100%, 50 to 75%, 55 to 100%, 55 to 75%, 60 to 100%or 60 to 75%.In some embodiments, the minimum residual disease negativity among subjects receiving treatment according to the dosage regimen and achieving CR, is at least 15%, at least 20%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%or at least 80%. The minimum residual disease negativity among subjects achieving CR may be 20%to 100%, 30%to 100%, 20%to 75%, 30%to 75%, 35 to 100%, 35 to 75%. 40 to 100%, 40 to 75%, 45 to 100%or 45 to 75%, 50 to 100%, 50 to 75%, 55 to 100%, 55 to 75%, 60 to 100%or 60 to 75%.In some embodiments, the dosage regime provides benefits in terms of the reduction of incidence or severity of adverse events, such as differentiation syndrome, whilst also achieving therapeutic efficacy. In particular the incidence of differentiation syndrome is in less than 20%, in particular less than 15%, in particular less than 10%, in particular less than 5%, in particular less than 1%of the patients treated by a dosage regimen as described herein.In some embodiments, the median duration of CR without minimal residual disease, in a population of subjects receiving treatment according to the dosage regimen is at least 20 weeks, at least 24 weeks, at least 28 weeks, at least 32 weeks, at least 36 weeks, at least 40 weeks, at least 44 weeks or at least 48 weeks.In some embodiments, the median duration of CR / CRh without minimal residual disease, in a population of subjects receiving treatment according to the dosage regimen is at least 20 weeks, at least 24 weeks, at least 28 weeks, at least 32 weeks, at least 36 weeks, at least 40 weeks, at least 44 weeks or at least 48 weeks.In some embodiments, the median duration of CR / CRh / CRi without minimal residual disease, in a population of subjects receiving treatment according to the dosage regimen is at least 20 weeks, at least 24 weeks, at least 28 weeks, at least 32 weeks, at least 36 weeks, at least 40 weeks, at least 44 weeks or at least 48 weeks.In any of the dosage regimens described herein, the compound may be administered as a monotherapy, unless use in combination is explicitly mentioned.The subject treated with a dosage regimen as described herein may be a subject that has previously undergone treatment for leukemia. The subject treated with a dosage regimen as described herein may be a subject that has previously had a stem cell transplant and / or has previously undergone venetoclax therapy.In some embodiments, administration of the compound to a subject according to a dosage regimen as described herein may provide a reduction of menin-KMT2A target gene expression in the subject, for example a reduction in MEIS1 expression. In some, but not all, responders a reduction in HOXA9 and / or FLT3 expression is also observed. Accordingly, a reduction in HOXA9 and / or FLT3 expression may further be provided. Administration of the compound may provide a reduction of at least 50%or at least 70%in MEIS1 expression. Administration of the compound may provide a reduction of at least 50%or at least 70%in HOXA9 expression. Administration of the compound may provide a reduction of at least 40%, at least 50%or at least 57%in FLT3 expression.In some, but not all, responders an induction of genes associated with differentiation, for example at least one of ITGAM and MNDA, is observed. In some embodiments, administration of the compound to a subject according to a dosage regimen as described herein may provide an induction of genes associated with differentiation, for example at least one of ITGAM and MNDA. Administration of the compound may provide an induction of at least 40%, at least 50%or at least 57%ITGAM. Administration of the compound may provide an induction of at least 10%, at least 15%or at least 16%of MNDA.In some, but not all, responders a reduction in blasts when compared with baseline is also observed. Accordingly, a reduction in blasts may further be provided. In some embodiments, administration of the compound to a subject according to a dosage regimen as described herein may provide a reduction in blasts. Administration of the compound may provide a reduction of at least 20%in blasts. Administration of the compound may provide a reduction of at least 30%in blasts. Administration of the compound may provide a reduction of at least 40%in blasts. Administration of the compound may provide a reduction of at least 50%in blasts. Administration of the compound may provide a reduction of at least 60%, at least 70%or at least 80%in blasts. Higher reduction in blasts, for example a reduction of at least 40%, at least 50%, at least 60%, at least 70%or at least 80%in blasts, may be observed for subjects with greater than 5%blasts (blast percentage) . In any of the above embodiments, the absolute blast percentage may preferably be 30%blasts or lower after treatment, 25%blasts or lower after treatment, in particular 20%blasts or lower after treatment, 15%blasts or lower after treatment, 10%blasts or lower after treatment, or 5%blasts or lower after treatment. In particular, in any of the above embodiments, the absolute bone marrow blast percentage may preferably be 25%bone marrow blasts or lower after treatment. The blast reduction referenced herein may refer to reduction of bone marrow blasts. The blast percentage referenced herein may refer to percentage of bone marrow blasts.The reductions in blasts described herein may lead to an assessment of response in a patient, in particular response in AML / ALL as described in Tables 1, 1b, 2 and 3 hereunder, in particular partial response (PR) , Morphologic leukemia-free state, CR (complete remission / response) , CRh (complete remission with partial hematologic recovery) , or CRi (complete remission with incomplete hematologic recovery) .Also described herein is a method of assessing a response in a patient who is treated with (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide or a pharmaceutically acceptable salt or solvate thereof, in a dosage regimen as described herein, by measuring the reduction in blasts as described herein. In particular a response in a patient having AML or ALL as described in Tables 1, 1b, 2 and 3 hereunder, in particular partial response (PR) , Morphologic leukemia-free state, CR (complete remission / response) , CRh (complete remission with partial hematologic recovery) , or CRi (complete remission with incomplete hematologic recovery) .In some embodiments, administration of the compound to a subject according to a dosage regimen as described herein may provide, when compared with baseline, a reduction in the percentage of KMT2A-altered cells. Administration of the compound may provide, when compared with baseline, a reduction in the percentage of KMT2A-altered cells of at least 50%, at least 70%or at least 90%. Administration of the compound may provide, when compared with baseline, a reduction in the percentage of NPM1 VAF, optionally a reduction in the percentage of NPM1 VAF of at least 40%, at least 50%, at least 60%or at least 73%.In some embodiments, administration of the compound to a subject according to a dosage regimen as described herein may provide reduction in KMT2A or NPM1 mutation burden.In some embodiments, administration of the compound to a subject according to a dosage regimen as described herein may provide reduction in nucleoporin 98 (NUP98) gene alteration or nucleoporin 214 gene (NUP214) alteration burden.In an embodiment, in any of the embodiments herein the subject may proceed to allogeneic hematopoietic stem cell transplantation.CombinationsMenin / MLL inhibitors (in particular (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof) may be administered alone or they can be used in combination with one or more additional therapeutic agents. In an embodiment, the Menin / MLL inhibitor (in particular (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof) is formulated in a separate dosage form than the additional therapeutic agent (s) . The additional therapeutic agent (s) may also each be formulated in a separate dosage form. Examples of additional therapeutic agents are AML-directed therapies. Examples of additional therapeutic agents are a DNA intercalating agent, a pyrimidine analog, a BCL-2 inhibitor, a hypomethylating agent or a fms-like receptor tyrosine kinase-3 (FLT3) kinase inhibitor.The menin-MLL inhibitor and the additional therapeutic agent (s) are administered in accordance with their dosing schedules for a time period, e.g. (i) simultaneously or sequentially in either order on the same day (s) within a time period (e.g., a 21-day period, or a 28-day period, or a 3-month period, or a 6-month period, or a one-year period, etc. ) , and / or e.g. (ii) on different days within a time period.A skilled person will understand that the term "BCL-2 inhibitor" refers to an agent that inhibits or reduces BCL-2 activity.A skilled person will understand that the term "hypomethylating agent" refers to an agent that inhibits or reduces DNA methylation.A skilled person will understand that the term "FLT-3 inhibitor" refers to tyrosine kinase inhibitors (TKI) classified into first and next generation inhibitors based on their potency and specificity for fms-like receptor tyrosine kinase-3 (FLT3) and their associated downstream targets.A skilled person will understand that the term “pyrimidine analog” refers to antimetabolites which mimic the structure of metabolic pyrimidines and that interfere with nucleic acid synthesis.Methods of treatments and medical uses described herein also apply to the combination of (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, in combination with one or more additional therapeutic agents.The present invention also provides a combination of a compound and one or more additional therapeutic agents for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 140-320mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein the compound is administered at a target daily dosage by dosing twice daily starting on day 4 of cycle 1.The present invention also provides a combination of a compound and one or more additional therapeutic agents for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 140-320mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein the compound is administered at a target daily dosage by dosing twice daily starting on day 4 of cycle 1.The present invention also provides a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage by dosing at 80mg BID or 100mg BID or 150mg BID, wherein the daily dosage is calculated based on the free base form of the compound, and wherein the compound is administered by dosing twice daily starting on day 4 of cycle 1.The present invention also provides a combination of a compound and one or more additional therapeutic agents for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage by dosing at 80mg BID or 100mg BID or 150mg BID, wherein the daily dosage is calculated based on the free base form of the compound, and wherein the compound is administered by dosing twice daily starting on day 4 of cycle 1.The present invention also provides a combination of a compound and one or more additional therapeutic agents for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound and a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the DNA intercalating agent and the pyrimidine analog are dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the DNA intercalating agent and the pyrimidine analog are also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a compound for use in combination with a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the DNA intercalating agent and the pyrimidine analog are dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the DNA intercalating agent and the pyrimidine analog are also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a combination of a compound and a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the DNA intercalating agent from day 1-3 in cycle 1;(ii) administrating the pyrimidine analog from day 1-7 in cycle 1;(iii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) administrating the DNA intercalating agent from day 1-3 in cycle 2 and each subsequent cycle;(v) administrating the pyrimidine analog from day 1-7 in cycle 2 and each subsequent cycle;(vi) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the DNA intercalating agent from day 1-3 in cycle 1;(ii) administrating the pyrimidine analog from day 1-7 in cycle 1;(iii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) administrating the DNA intercalating agent from day 1-3 in cycle 2 and each subsequent cycle;(v) administrating the pyrimidine analog from day 1-7 in cycle 2 and each subsequent cycle;(vi) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the DNA intercalating agent from day 1-3 in cycle 1;(ii) administrating the pyrimidine analog from day 1-7 in cycle 1;(iii) no administration of the compound from day 1-3 of cycle 1;(iv) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(v) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the DNA intercalating agent from day 1-3 in cycle 1;(ii) administrating the pyrimidine analog from day 1-7 in cycle 1;(iii) no administration of the compound from day 1-3 of cycle 1;(iv) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(v) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the DNA intercalating agent from day 1-3 in cycle 1;(ii) administrating the pyrimidine analog from day 1-7 in cycle 1;(iii) no administration of the compound from day 1-3 of cycle 1;(iv) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the DNA intercalating agent from day 1-3 in cycle 1;(ii) administrating the pyrimidine analog from day 1-7 in cycle 1;(iii) no administration of the compound from day 1-3 of cycle 1;(iv) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating daunorubicin or idarubicin from day 1-3 in cycle 1;(ii) administrating cytarabine from day 1-7 in cycle 1;(iii) no administration of the compound from day 1-3 of cycle 1;(iv) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating daunorubicin or idarubicin from day 1-3 in cycle 1;(ii) administrating cytarabine from day 1-7 in cycle 1;(iii) no administration of the compound from day 1-3 of cycle 1;(iv) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination comprising with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating daunorubicin or idarubicin from day 1-3 in cycle 1;(ii) administrating cytarabine from day 1-7 in cycle 1;(iii) no administration of the compound from day 1-3 of cycle 1;(iv) a target dosage period in cycle 1 starting on day 4 (+3 day window) of cycle 1 wherein the compound is administered at a target daily dosage of 180-320 mg provided by twice daily dosing, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the daunorubicin at a dose of 60 mg / m2 / day from day 1-3 in cycle 1; or administrating the idarubicin at a dose of 10-12 mg / m2 / day from day 1-3 in cycle 1;(ii) administrating the cytarabine at a dose of 200 mg / m2 / day from day 1-7 in cycle 1;(iii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) administrating the daunorubicin at a dose of 60 mg / m2 / day from day 1-3 in cycle 2 and each subsequent cycle; or administrating the idarubicin at a dose of 10-12 mg / m2 / day from day 1-3 in cycle 2 and each subsequent cycle;(v) administrating cytarabine at a dose of 200 mg / m2 / day from day 1-7 in cycle 2 and each subsequent cycle;(vi) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the daunorubicin at a dose of 60 mg / m2 / day from day 1-3 in cycle 1; or administrating the idarubicin at a dose of 10-12 mg / m2 / day from day 1-3 in cycle 1;(ii) administrating the cytarabine at a dose of 200 mg / m2 / day from day 1-7 in cycle 1;(iii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) administrating the daunorubicin at a dose of 60 mg / m2 / day from day 1-3 in cycle 2 and each subsequent cycle; or administrating the idarubicin at a dose of 10-12 mg / m2 / day from day 1-3 in cycle 2 and each subsequent cycle;(v) administrating cytarabine at a dose of 200 mg / m2 / day from day 1-7 in cycle 2 and each subsequent cycle;(vi) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the daunorubicin at a dose of 60 mg / m2 / day from day 1-3 in cycle 1; or administrating the idarubicin at a dose of 10-12 mg / m2 / day from day 1-3 in cycle 1;(ii) administrating the cytarabine at a dose of 200 mg / m2 / day from day 1-7 in cycle 1;(iii) no administration of the compound from day 1-3 of cycle 1;(iv) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(v) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the daunorubicin at a dose of 60 mg / m2 / day from day 1-3 in cycle 1; or administrating the idarubicin at a dose of 10-12 mg / m2 / day from day 1-3 in cycle 1;(ii) administrating the cytarabine at a dose of 200 mg / m2 / day from day 1-7 in cycle 1;(iii) no administration of the compound from day 1-3 of cycle 1;(iv) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(v) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) the cytarabine and daunorubicin or idarubicin are dosed according to their label or marketing authorization.The present invention also provides a compound for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) the cytarabine and daunorubicin or idarubicin are dosed according to their label or marketing authorization.The present invention also provides a combination of a compound with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) the DNA intercalating agent and pyrimidine analog are dosed according to their label or marketing authorization.The present invention also provides a compound for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) the DNA intercalating agent and pyrimidine analog are dosed according to their label or marketing authorization.The present invention also provides a combination of a compound with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound, the cytarabine and the daunorubicin or idarubicin, are administered to a subject in need thereof according to the dosage regimen of Tables 34 and 35.The present invention also provides a compound for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound, the cytarabine and the daunorubicin or idarubicin, are administered to a subject in need thereof according to the dosage regimen of Tables 34 and 35.The present invention also provides a combination of a compound with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, in particular AML with KMT2A or NPM1 alterations, more in particular newly diagnosed AML with KMT2A or NPM1 alterations, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound, the cytarabine and the daunorubicin or idarubicin, are administered to a subject in need thereof according to the dosage regimen below:The present invention also provides a compound for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, in particular AML with KMT2A or NPM1 alterations, more in particular relapsed / refractory or newly diagnosed AML with KMT2A or NPM1 alterations,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound, the cytarabine and the daunorubicin or idarubicin, are administered to a subject in need thereof according to the dosage regimen below:The present invention also provides a compound for use in combination comprising one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog, for use in a method of treating cancer, in particular AML with KMT2A or NPM1 alterations, more in particular relapsed / refractory or newly diagnosed AML with KMT2A or NPM1 alterations,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the pyrimidine analog is cytarabine and wherein the DNA intercalating agent is daunorubicin or idarubicin,wherein the compound, the cytarabine and the daunorubicin or idarubicin, are administered to a subject in need thereof according to a dosage regimen comprising:The present invention also provides a combination of a compound and a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound and venetoclax and azacytidine for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 160mg provided by dosing at 80mg BID, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with venetoclax and azacytidine for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 160mg provided by dosing at 80mg BID, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound and venetoclax and azacytidine for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200mg provided by dosing at 100mg BID, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with venetoclax and azacytidine for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200mg provided by dosing at 100mg BID, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound and venetoclax and azacytidine for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 300mg provided by dosing at 150mg BID, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with venetoclax and azacytidine for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 300mg provided by dosing at 150mg BID, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the BCL-2 inhibitor and the hypomethylating agent are dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the BCL-2 inhibitor and the hypomethylating agent are also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the BCL-2 inhibitor and the hypomethylating agent are dosed;(iii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the BCL-2 inhibitor and the hypomethylating agent are also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine, and wherein the BCL-2 inhibitor is venetoclax;wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the azacytidine for 7 days at 75mg / m2 daily during the first 9 days in cycle 1;(ii) administrating venetoclax at a daily dosage of 100 mg on day 1 of cycle 1; at a daily dosage of 200 mg on day 2 of cycle 1; at a daily dosage of 400 mg on day 3 of cycle 1; at a daily dosage of 400 mg for the rest of cycle 1;(iii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) administrating the azacytidine for 7 days at 75mg / m2 daily during the first 9 days in cycle 2 and each subsequent cycle;(v) administrating venetoclax at a daily dosage of 400 mg in cycle 2 and each subsequent cycle;(vi) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine, and wherein the BCL-2 inhibitor is venetoclax;wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the azacytidine for 7 days at 75mg / m2 daily during the first 9 days in cycle 1;(ii) administrating venetoclax at a daily dosage of 100 mg on day 1 of cycle 1; at a daily dosage of 200 mg on day 2 of cycle 1; at a daily dosage of 400 mg on day 3 of cycle 1; at a daily dosage of 400 mg for the rest of cycle 1;(iii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) administrating the azacytidine for 7 days at 75mg / m2 daily during the first 9 days in cycle 2 and each subsequent cycle;(v) administrating venetoclax at a daily dosage of 400 mg in cycle 2 and each subsequent cycle;(vi) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a BCL-2 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a BCL-2 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a BCL-2 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a BCL-2 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a BCL-2 for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with a BCL-2 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound and a BCL-2 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the BCL-2 inhibitor is dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the BCL-2 inhibitor is also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a compound for use in combination with a BCL-2 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the BCL-2 inhibitor is dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the BCL-2 inhibitor is also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a combination of a compound and a BCL-2 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the BCL-2 inhibitor is venetoclax,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating venetoclax at a daily dosage of 100 mg on day 1 of cycle 1; at a daily dosage of 200 mg on day 2 of cycle 1; at a daily dosage of 400 mg on day 3 of cycle 1; at a daily dosage of 400 mg for the rest of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) administrating venetoclax at a daily dosage of 400 mg in cycle 2 and each subsequent cycle;(iv) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a BCL-2 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the BCL-2 inhibitor is venetoclax,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating venetoclax at a daily dosage of 100 mg on day 1 of cycle 1; at a daily dosage of 200 mg on day 2 of cycle 1; at a daily dosage of 400 mg on day 3 of cycle 1; at a daily dosage of 400 mg for the rest of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) administrating venetoclax at a daily dosage of 400 mg in cycle 2 and each subsequent cycle;(iv) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound and a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the hypomethylating agent is dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the hypomethylating agent is also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a compound for use in combination with a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the hypomethylating agent is dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the hypomethylating agent is also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a combination of a compound and a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the azacytidine for 7 days at 75mg / m2 daily during the first 9 days in cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) administrating the azacytidine for 7 days at 75mg / m2 daily during the first 9 days in cycle 2 and each subsequent cycle;(iv) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) administrating the azacytidine for 7 days at 75mg / m2 daily during the first 9 days in cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) administrating the azacytidine for 7 days at 75mg / m2 daily during the first 9 days in cycle 2 and each subsequent cycle;(iv) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a BCL-2 inhibitor and / or a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine, and wherein the BCL-2 inhibitor is venetoclax;wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) the azacytidine and / or venetoclax are dosed according to their label or marketing authorization.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and / or a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine, and wherein the BCL-2 inhibitor is venetoclax; wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) the azacytidine and / or venetoclax are dosed according to their label or marketing authorization.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and / or a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine, and wherein the BCL-2 inhibitor is venetoclax; wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) the azacytidine and / or venetoclax administration are guided by the approved label, in particular venetoclax has a dose ramp-up from day 1 till day 4 in cycle 1.The present invention also provides a combination of a compound and a BCL-2 inhibitor and / or a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof;wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) the BCL-2 inhibitor and / or a hypomethylating agent are dosed according to their label or marketing authorization.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and / or a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof;wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) no administration of the compound from day 1-3 of cycle 1;(ii) a target dosage period in cycle 1 starting on day 4 of cycle 1 wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iii) a target dosage period in cycle 2 and each subsequent cycle starting on day 1 of the cycle wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound;(iv) the BCL-2 inhibitor and / or a hypomethylating agent are dosed according to their label or marketing authorization.The present invention also provides a combination of a compound and a BCL-2 inhibitor and / or a hypomethylating agent for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine, and wherein the BCL-2 inhibitor is venetoclax;wherein the compound, the azacytidine and / or venetoclax, are administered to a subject in need thereof according to the dosage regimen of Table 33.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine, and wherein the BCL-2 inhibitor is venetoclax; wherein the compound, the azacytidine and / or venetoclax, are administered to a subject in need thereof according to the dosage regimen of Table 33.The present invention also provides a combination of a compound and a BCL-2 inhibitor and / or a hypomethylating agent for use in a method of treating cancer, in particular AML with KMT2A or NPM1 alterations, more in particular relapsed / refractory or newly diagnosed AML with KMT2A or NPM1 alterations, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine, and wherein the BCL-2 inhibitor is venetoclax; wherein the compound, the azacytidine and / or venetoclax, are administered to a subject in need thereof according to the dosage regimen below:The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer, in particular AML with KMT2A or NPM1 alterations, more in particular relapsed / refractory or newly diagnosed AML with KMT2A or NPM1 alterations,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, and wherein the hypomethylating agent is azacytidine, and wherein the BCL-2 inhibitor is venetoclax; wherein the compound, the azacytidine and / or venetoclax, are administered to a subject in need thereof according to the dosage regimen below:The daily amounts dosed to the subject for venetoclax might be reduced by 50%in case the subject is on concomitant P-gp or moderate CYP3A4 inhibitors. The duration of venetoclax treatment in each of the cycles might be modified (cycle reduced by 7 days) in case of toxicities.The present invention also provides a combination of a compound and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the FLT-3 inhibitor is dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the FLT-3 inhibitor is also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a compound for use in combination with a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the FLT-3 inhibitor is dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the FLT-3 inhibitor is also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the BCL-2 inhibitor and the FLT-3 inhibitor are dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the BCL-2 inhibitor and the FLT-3 inhibitor are also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the BCL-2 inhibitor and the FLT-3 inhibitor are dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the BCL-2 inhibitor and the FLT-3 inhibitor are also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a combination of a compound, a FLT-3 inhibitor and a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a FLT-3 inhibitor, a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound, a FLT-3 inhibitor and a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with a FLT-3 inhibitor, a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound, a FLT-3 inhibitor and a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a FLT-3 inhibitor a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a combination of a compound, a FLT-3 inhibitor and a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the FLT-3 inhibitor, DNA intercalating agent and the pyrimidine analog are dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the FLT-3 inhbitor, DNA intercalating agent and the pyrimidine analog are also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a compound for use in combination with a FLT-3 inhibitor, a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the FLT-3 inhibitor, DNA intercalating agent and the pyrimidine analog are dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the FLT-3 inhibitor, DNA intercalating agent and the pyrimidine analog are also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a hypomethylating agent and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent and a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a hypomethylating agent and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) an initial dosage period wherein the compound is administered at an initial daily dosage;(ii) optionally, a step-up dosage period wherein the compound is administered at a step-up daily dosage, wherein the step-up daily dosage is greater than the initial daily dosage; and(iii) a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the target dosage level is greater than the initial daily dosage and the step-up daily dosage, where present,wherein all daily dosages are calculated based on the free base form of the compound.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a hypomethylating agent and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound,and wherein administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage.The present invention also provides a combination of a compound and a BCL-2 inhibitor and a hypomethylating agent and a FLT-3 inhibitor for use in a method of treating cancer, wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the BCL-2 inhibitor, hypomethylating agent and the FLT-3 inhibitor are dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the BCL-2 inhibitor, hypomethylating agent and the FLT-3 inhibitor are also dosed during part of the target dosage period or during the complete target dosage period.The present invention also provides a compound for use in combination with a BCL-2 inhibitor and a hypomethylating agent and a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising:(i) a period wherein only the BCL-2 inhibitor, hypomethylating agent and the FLT-3 inhibitor are dosed;(ii) a target dosage periodwherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound, and wherein optionally the BCL-2 inhibitor, hypomethylating agent and the FLT-3 inhibitor are also dosed during part of the target dosage period or during the complete target dosage period.Any embodiment herein wherein the compound is for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog or subgroups thereof, wherein an induction and optional re-induction period, a consolidation period and continuation therapy are applied.Any embodiment herein wherein the compound is for use in combination with one or more additional therapeutic agents comprising a DNA intercalating agent and a pyrimidine analog or subgroups thereof, wherein an induction and optional re-induction period, a consolidation period and continuation therapy are applied wherein1) the compound, the DNA intercalating agent and the pyrimidine analog are co-administered to a subject in need thereof during an induction and optionally re-induction period,2) the compound and the pyrimidine analog are co-administered to a subject in need thereof during a consolidation period,3) the compound is administered to a subject in need thereof during continuation therapy.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use in combination with a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer as described in other embodiments,wherein an induction and optional re-induction period, a consolidation period and continuation therapy are applied,whereby the compound is administered during the induction period, re-induction period, consolidation period and continuation therapy in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use in combination with a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer as described in other embodiments,wherein1) the compound, the DNA intercalating agent and the pyrimidine analog are co-administered to a subject in need thereof during an induction and optionally re-induction period,2) the compound and the pyrimidine analog are co-administered to a subject in need thereof during a consolidation period,3) the compound is administered to a subject in need thereof during continuation therapy,whereby the compound is administered during the induction period, re-induction period, consolidation period and continuation therapy in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use in combination with a DNA intercalating agent being daunorubicin or idarubicin, and a pyrimidine analog being cytarabine, for use in a method of treating cancer as described in other embodiments,wherein1) the compound, the DNA intercalating agent and the pyrimidine analog are co-administered to a subject in need thereof during an induction and optionally re-induction period,2) the compound and the pyrimidine analog are co-administered to a subject in need thereof during a consolidation period,3) the compound is administered to a subject in need thereof during continuation therapy,whereby the compound is administered during the induction period, re-induction period, consolidation period and continuation therapy in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use in combination with a DNA intercalating agent being daunorubicin or idarubicin, and a pyrimidine analog being cytarabine, for use in a method of treating cancer as described in other embodiments, comprising1) the compound, the DNA intercalating agent and the pyrimidine analog are co-administered to a subject in need thereof during an induction and optionally re-induction period,2) the compound and the pyrimidine analog are co-administered to a subject in need thereof during a consolidation period,3) the compound is administered to a subject in need thereof during continuation therapy,whereby the compound is administered during the induction period, re-induction period, consolidation period and continuation therapy in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 180-320mg,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction,2) in combination with cytarabine consolidation, and3) as maintenance therapy following consolidation chemotherapy,for use in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged, wherein the compound is administered to a subject in need thereof in one or more of the dosing regimens as described herein.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction,2) in combination with cytarabine consolidation, and3) as maintenance therapy following consolidation chemotherapy,for use in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with cytarabine consolidation, and3) as maintenance therapy following consolidation chemotherapy,for use in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with cytarabine consolidation, and3) as maintenance therapy following consolidation chemotherapy,for use in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 (+3 day window) of cycle 1, wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as maintenance therapy following consolidation chemotherapy in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction,2) in combination with cytarabine consolidation, and3) as maintenance therapy following consolidation chemotherapy,for use in a method of treating newly diagnosed AML with NPM1 or KMT2A alterations, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with cytarabine consolidation, and3) as maintenance therapy following consolidation chemotherapy,for use in a method of treating newly diagnosed AML with NPM1 or KMT2A alterations, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with cytarabine consolidation, and3) as maintenance therapy following consolidation chemotherapy,for use in a method of treating newly diagnosed AML with NPM1 or KMT2A alterations, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as maintenance therapy following consolidation chemotherapy in a method of treating newly diagnosed AML with NPM1 or KMT2A alterations,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction,2) in combination with cytarabine consolidation, and3) as maintenance therapy following consolidation chemotherapy,for use in a method of treating cancer,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with cytarabine consolidation, and3) as maintenance therapy following consolidation chemotherapy,for use in a method of treating cancer,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with cytarabine consolidation, and3) as maintenance therapy following consolidation chemotherapy,for use in a method of treating cancer,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as maintenance therapy following consolidation chemotherapy in a method of treating cancer, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as maintenance therapy following consolidation chemotherapy in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as maintenance therapy following consolidation chemotherapy in a method of treating newly diagnosed AML with NPM1 or KMT2A alterations.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as maintenance therapy following consolidation chemotherapy in a method of treating cancer.In an embodiment, the maintenance therapy is maintenance monotherapy.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating cancer,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 180-320 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged, wherein the compound is administered to a subject in need thereof in one or more of the dosing regimens as described herein.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as part of maintenance therapy following consolidation therapy in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating newly diagnosed AML with NPM1 or KMT2A alterations, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating newly diagnosed AML with NPM1 or KMT2A alterations, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating newly diagnosed AML with NPM1 or KMT2A alterations, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as part of maintenance therapy following consolidation therapy in a method of treating newly diagnosed AML with NPM1 or KMT2A alterations,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating cancer,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating cancer,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use1) in combination with cytarabine and anthracycline induction and optionally re-induction, wherein the anthracycline is daunorubicin or idarubicin,2) in combination with consolidation therapy comprising cytarabine consolidation, and3) as part of maintenance therapy following consolidation therapy,for use in a method of treating cancer,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200 mg provided by dosing at 100 mg BID starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as part of maintenance therapy following consolidation therapy in a method of treating cancer, wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 200-300 mg provided by BID dosing starting on day 4 (+3 day window) of cycle 1,wherein the daily dosage is calculated based on the free base form of the compound.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as part of maintenance therapy following consolidation therapy in a method of treating newly diagnosed AML that is NPM1 mutated or KMT2A rearranged.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as part of maintenance therapy following consolidation therapy in a method of treating newly diagnosed AML with NPM1 or KMT2A alterations.In an embodiment, the present invention relates toa compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,for use as part of maintenance therapy following consolidation therapy in a method of treating cancer.In an embodiment, in any of the embodiments herein the subject may proceed to allogeneic hematopoietic stem cell transplantation. In an embodiment, in any of the embodiments herein the subject may proceed to allogeneic hematopoietic stem cell transplantation after completion of consolidation therapy. In an embodiment, in any of the embodiments herein the subject may proceed to allogeneic hematopoietic stem cell transplantation after completion of consolidation therapy with cytarabine. In an embodiment, the subject may proceed to allogeneic hematopoietic stem cell transplantation after completion of consolidation therapy, and maintenance therapy with the compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof) . In an embodiment, the subject may proceed to allogeneic hematopoietic stem cell transplantation after completion of consolidation therapy with cytarabine, and maintenance therapy with the compound (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof) .In an embodiment, in any of the embodiments herein comprising consolidation (chemo) therapy, the consolidation (chemo) therapy is with a pyrimidine analog. In an embodiment, in any of the embodiments herein comprising consolidation (chemo) therapy, the consolidation therapy is with cytarabine.In an embodiment, in any of the embodiments herein comprising an anthracycline and a pyrimidine analog,the anthracycline may be dosed from day 1-3 of the induction period and optionally day 1-3 of the re-induction period,the pyrimidine analog may be dosed from day 1-7 of the induction period and optionally day 1-7 of the re-induction period,the pyrimidine analog may be dosed during the consolidation period.In an embodiment, in any of the embodiments herein comprising daunorubicin or idarubicin, and cytarabine,daunorubicin or idarubicin may be dosed from day 1-3 of the induction period and optionally day 1-3 of the re-induction period,cytarabine may be dosed from day 1-7 of the induction period and optionally day 1-7 of the re-induction period,cytarabine may be dosed during cytarabine consolidation.In the embodiments above, the target daily dosage in particular is provided by dosing at 100 mg BID, 150 mg BID or 200 mg BID.In an embodiment, the BCL-2 and FLT-3 inhibitors comprise dosing according to their label or marketing authorization.In an embodiment, the BCL-2 inhibitor, hypomethylating agent and FLT-3 inhibitor comprise dosing according to their label or marketing authorization.In an embodiment, the venetoclax and azacytidine comprise dosing according to Table 33.In an embodiment, the cytarabine plus daunorubicin or idarubicin comprise dosing according to Tables 34 and 35.In an embodiment, the FLT-3 inhibitor comprises dosing according to its label or marketing authorization.In an embodiment, the DNA intercalating agent, the pyrimidine analog and FLT-3 inhibitor comprise dosing according to their label or marketing authorization.In an embodiment, the one or more additional therapeutic agents comprise dosing according to their label or marketing authorization.In an embodiment, there is provided a process for preparing a combination as defined herein comprising:- bringing into association each of the components (e.g. as separate pharmaceutical formulations) of the combination and co-packaging (e.g. as a kit of parts) or indicating that the intended use is in combination (with the other components) .In a particular embodiment, venetoclax administration starts with a 3 day ramp up to the full treatment dose of 400 mg daily, azacitidine at 75 mg / m2 is administered daily for 7 days of each cycle, and the compound is administered twice daily continuously starting on day 4 of cycle 1.In a particular embodiment, venetoclax administration is continuous following dose ramp-up and guided by the approved label which allows for reduced duration of therapy in subsequent cycles due to prolonged cytopenia.In a particular embodiment, the compound is administered at a target daily dosage by dosing twice daily continuously starting on day 4 of cycle 1. In a particular embodiment, the compound is administered by dosing twice daily continuously starting on day 4 of cycle 1.In a particular embodiment, interruption of venetoclax is allowed. In a particular embodiment, interruption of venetoclax is allowed if adequate blast suppression is achieved.It will be clear that the initial dosage is according to the embodiments described in the section ‘dosage regimens’ . It will be clear that the target daily dosage may be according to any of the embodiments described in the section ‘dosage regimens’ . It will be clear that the target daily dosage may be provided by dosing according to any of the embodiments described in the section ‘dosage regimens’ .In particular the target daily dosage is 80-300mg, more in particular 100-300mg. In some embodiments, the target daily dosage is 140-180mg, 120-200mg, 180-220mg, 160-240mg, 180-320mg, 280-320mg, 260-340mg or 180-340mg. In particular, the target daily dosage of the compound in the combination is provided by twice daily (BID) dosing. The target daily dosage may be provided by dosing at 70-90mg BID, 60-100mg BID, 90-110mg BID, 80-120mg BID, 90-160mg BID, 140-160mg BID, 130-170mg BID, 90-170mg BID. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID.In particular a cycle is 28-days, or 21 days. In particular a cycle is 28-days.In an embodiment, the dosage regimen starts with a period wherein only one or more of the additional therapeutic agents are dosed.In an embodiment, the dosage regimen starts with a period wherein only one or more of the additional therapeutic agents are dosed, and the target dosage period of the compound starts at least 3 days after the start of the dosage regimen,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide or a pharmaceutically acceptable salt or solvate thereof.In an embodiment, the dosage regimen starts with a period wherein only one or more of the additional therapeutic agents are dosed, and the target dosage period of the compound starts on day 4 after the start of the dosage regimen,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof.In some embodiments, administration of the compound starts on day 3 after start of the dosage regimen and is at the target daily dosage. In some embodiments, administration of the compound starts on day 4 after start of the dosage regimen and is at the target daily dosage. In some embodiments, administration of the compound starts on day 5 after start of the dosage regimen and is at the target daily dosage. In some embodiments, administration of the compound starts on day 6 after start of the dosage regimen and is at the target daily dosage. In some embodiments, administration of the compound starts on day 7 after start of the dosage regimen and is at the target daily dosage. In some embodiments, administration of the compound starts on day 8 after start of the dosage regimen and is at the target daily dosage.In some embodiments, administration of the compound starts on day 9 after start of the dosage regimen and is at the target daily dosage. In some embodiments, administration of the compound starts on day 10 after start of the dosage regimen and is at the target daily dosage.In some embodiments, administration of the compound starts at the target daily dosage at least 3 days after the start of the dosage regimen, at least 4 days after the start of the dosage regimen, at least 4 days after the start of the dosage regimen, at least 5 days after the start of the dosage regimen, at least 3 to 56 days after the start of the dosage regimen, 3 to 28 days after the start of the dosage regimen, 3 to 21 days after the start of the dosage regimen or 3 to 6 days after the start of the dosage regimen. In some embodiments, a target dosage period starts on day 3 of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on day 4 of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on day 5 of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on day 6 of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on day 7 of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on day 8 of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on day 9 of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on day 10 of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on or after day 3 of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on or after day 4 of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on day 4 (+3 day window) of cycle 1 wherein the compound is administered at a target daily dosage. In some embodiments, a target dosage period starts on day 4, 5, 6 or 7 of cycle 1 wherein the compound is administered at a target daily dosage. Day 4 (+3 day window) means day 4, 5, 6 or 7. All embodiments referring to a dosing that starts on day 4 after start of the dosage regimen (Cycle 1 Day 4) are also included herein with “day 4” being replaced by “day 4 (+3 day window) ” . All embodiments referring to a target dosage period that starts on day 4 after start of the dosage regimen (Cycle 1 Day 4) are also included herein with “day 4” being replaced by “day 4 (+3 day window) ” .In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise daunorubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise doxorubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise idarubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise azacytidine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise sorafenib. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise sunitinib. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise KW-2449. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise sorafenib and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise sunitinib and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 50 mg BID, and the one or more additional therapeutic agents comprise KW-2449 and venetoclax.In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise daunorubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise doxorubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise idarubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise azacytidine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise sorafenib. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise sunitinib. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise KW-2449. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise sorafenib and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise sunitinib and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 80 mg BID, and the one or more additional therapeutic agents comprise KW-2449 and venetoclax.In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise daunorubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise doxorubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise idarubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise azacytidine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise sorafenib. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise sunitinib. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise KW-2449. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise sorafenib and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise sunitinib and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise KW-2449 and venetoclax.In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise sorafenib, azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise sunitinib, azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) , azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) , azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) , azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) , azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) , azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise KW-2449, azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) , cytarabine and daunorubicin. In particular, the target daily dosage of the compound in the combination is provided by dosing at 100 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) , cytarabine and idarubicin.In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise daunorubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise doxorubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise idarubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise azacytidine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise sorafenib. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise sunitinib. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise KW-2449. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise sorafenib and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise sunitinib and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise KW-2449 and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise sorafenib, azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise sunitinib, azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) , azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) , azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) , azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) , azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) , azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise KW-2449, azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) , cytarabine and daunorubicin. In particular, the target daily dosage of the compound in the combination is provided by dosing at 150 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) , cytarabine and idarubicin. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise daunorubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise doxorubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise idarubicin and cytarabine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise azacytidine and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise azacytidine. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise sorafenib. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise sunitinib. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) . In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise KW-2449. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise sorafenib and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise sunitinib and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise midostaurin (PKC412) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise lestaurtinib (CEP-701) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise tandutinib (MLN518) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise quizartinib (AC220) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise gilteritinib (ASP2215) and venetoclax. In particular, the target daily dosage of the compound in the combination is provided by dosing at 200 mg BID, and the one or more additional therapeutic agents comprise KW-2449 and venetoclax.In any of the embodiments described above, the target daily dosage may be provided by dosing at 70-90mg BID. In any of the embodiments described above, the target daily dosage may be provided by dosing at 60-100mg BID. In any of the embodiments described above, the target daily dosage may be provided by dosing at 90-110mg BID. In any of the embodiments described above, the target daily dosage may be provided by dosing at 80-120mg BID. In any of the embodiments described above, the target daily dosage may be provided by dosing at 90-160mg BID. In any of the embodiments described above, the target daily dosage may be provided by dosing at 140-160mg BID. In any of the embodiments described above, the target daily dosage may be provided by dosing at 130-170mg BID. In any of the embodiments described above, the target daily dosage may be provided by dosing at 90-170mg BID.In a particular embodiment, the one or more additional therapeutic agents comprise dosing according to their label or marketing authorization. In a particular embodiment, the one or more additional therapeutic agents comprise dosing according to their prescribed use. In a particular embodiment, the subject received a 7+3 regimen of daunorubicin 60mg / m2 / day IV or idarubicin 12mg / m2 / day IV and cytarabine 200mg / m2 / day, while the compound was dosed orally twice daily commencing on day 4 of the dosing regimen and was dosed continuously. In a particular embodiment, the subject received a 7+3 regimen of daunorubicin 60mg / m2 / day IV or idarubicin 12mg / m2 / day IV and cytarabine 200mg / m2 / day, while the compound was dosed orally twice daily commencing on day 4 (+3 day window) of the dosing regimen and was dosed continuously.According to embodiments, the BCL-2 inhibitor includes, but is not limited to, venetoclax.According to embodiments, the BCL-2 inhibitor is venetoclax.According to embodiments, the hypomethylating agent includes, but is not limited to, azacytidine and decitabine.According to embodiments, the hypomethylating agent is azacytidine.According to embodiments, the hypomethylating agent is decitabine.According to embodiments, the BCL-2 inhibitor is venetoclax, and the hypomethylating agent is azacytidine.According to embodiments, the BCL-2 inhibitor is venetoclax, and the hypomethylating agent is decitabine.According to embodiments, the DNA intercalating agent includes, but is not limited to, an anthracycline (e.g., daunorubicin, doxorubicin, idarubicin) .According to embodiments, the DNA intercalating agent is an anthracycline.According to embodiments, the DNA intercalating agent is daunorubicin.According to embodiments, the DNA intercalating agent is doxorubicin.According to embodiments, the DNA intercalating agent is idarubicin.According to embodiments, the pyrimidine analog includes, but is not limited to, cytarabine (ARA-C) or gemcitabine.According to embodiments, the pyrimidine analog is cytarabine.According to embodiments, the DNA intercalating agent is daunorubicin, and the pyrimidine analog is cytarabine.According to embodiments, the DNA intercalating agent is doxorubicin, and the pyrimidine analog is cytarabine.According to embodiments, the DNA intercalating agent is idarubicin, and the pyrimidine analog is cytarabine.According to embodiments, the FLT3-inhibitor includes, but is not limited to, sorafenib, sunitinib, midostaurin (PKC412) , lestaurtinib (CEP-701) , tandutinib (MLN518) , quizartinib (AC220) , gilteritinib (ASP2215) , and KW-2449.According to embodiments, the FLT3-inhibitor is gilteritinib (ASP2215) . According to embodiments, the FLT3-inhibitor is midostaurin (PKC412) . According to embodiments, the FLT3-inhibitor is sorafenib. According to embodiments, the FLT3-inhibitor is sunitinib. According to embodiments, the FLT3-inhibitor is lestaurtinib (CEP-701) . According to embodiments, the FLT3-inhibitor is tandutinib (MLN518) . According to embodiments, the FLT3-inhibitor is quizartinib (AC220) . According to embodiments, the FLT3-inhibitor is KW-2449.For combinations as described herein or for the compound for use in combination, the cancer in particular is leukemia, more in particular AML, even more in particular relapsed / refractory or newly diagnosed AML with NPM1 or KMT2A gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is relapsed / refractory AML with NPM1 or KMT2A gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is newly diagnosed AML with NPM1 or KMT2A gene alterations.For combinations as described herein or for the compound for use in combination, the cancer in particular is leukemia, more in particular AML, even more in particular relapsed / refractory or newly diagnosed AML with NPM1, KMT2A, NUP98 or NUP214 gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is relapsed / refractory AML with NPM1, KMT2A, NUP98 or NUP214 gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is newly diagnosed AML with NPM1, KMT2A, NUP98 or NUP214 gene alterations.For combinations as described herein or for the compound for use in combination, the cancer in particular is leukemia, more in particular AML, even more in particular relapsed / refractory or newly diagnosed AML with NPM1, KMT2A or NUP98 gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is relapsed / refractory AML with NPM1, KMT2A or NUP98 gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is newly diagnosed AML with NPM1, KMT2A or NUP98 gene alterations.For combinations as described herein or for the compound for use in combination, the cancer in particular is leukemia, more in particular AML, even more in particular relapsed / refractory or newly diagnosed AML with NPM1 and / or KMT2A gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is relapsed / refractory AML with NPM1 and / or KMT2A gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is newly diagnosed AML with NPM1 and / or KMT2A gene alterations.For combinations as described herein or for the compound for use in combination, the cancer in particular is leukemia, more in particular AML, even more in particular relapsed / refractory or newly diagnosed AML with NPM1, KMT2A, NUP98 and / or NUP214 gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is relapsed / refractory AML with NPM1, KMT2A, NUP98 and / or NUP214 gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is newly diagnosed AML with NPM1, KMT2A, NUP98 and / or NUP214 gene alterations.For combinations as described herein or for the compound for use in combination, the cancer in particular is leukemia, more in particular AML, even more in particular relapsed / refractory or newly diagnosed AML with NPM1, KMT2A and / or NUP98 gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is relapsed / refractory AML with NPM1, KMT2A and / or NUP98 gene alterations. For combinations as described herein or for the compound for use in combination, the cancer in particular is newly diagnosed AML with NPM1, KMT2A and / or NUP98 gene alterations.The leukemia, or any subgroup thereof, may be a leukemia having one or more co-mutations. The one or more co-mutations may be selected from FLT3, DNMT3A, NRAS, TP53, KRAS, TET2, IDH2, and IDH1 mutations. The one or more co-mutations may be selected from FLT3, DNMT3A, NRAS, TP53, KRAS, TET2, IDH2, IDH1, WT1, ASXL1, SRSF2, PPM1D, MEN1 and RAD21 mutations. The co-mutation may be a FLT3 (FLT-3) mutation.The cancers, leukemias, or any subgroup thereof as described herein, may optionally have a FLT3 (FLT-3) co-mutation. In an embodiment, in case the one or more additional therapeutic agents comprise a FLT-3 inhibitor, a FLT3 (FLT-3) co-mutation is present.In an embodiment, the subject is ineligible for intensive chemotherapy. In an embodiment the subject is eligible for intensive chemotherapy. In an embodiment, the subject has newly diagnosed AML and is ineligible for intensive chemotherapy. In an embodiment, the subject has newly diagnosed AML and is ineligible for intensive chemotherapy, and the compound is for use in combination with azacytidine and venetoclax. In an embodiment, the subject has newly diagnosed NPM1-mutated (NPM1m) or KMT2A-rearranged (KMT2Ar) AML and is ineligible for intensive chemotherapy, and the compound is for use in combination with azacytidine and venetoclax. In an embodiment, the subject has newly diagnosed AML with NPM1 or KMT2A alterations and is ineligible for intensive chemotherapy, and the compound is for use in combination with azacytidine and venetoclax. In an embodiment the subject is has newly diagnosed AML and is eligible for intensive chemotherapy. In an embodiment the subject has newly diagnosed AML and is eligible for intensive chemotherapy, and the compound is for use in combination with a DNA intercalating agent and a pyrimidine analog. In an embodiment the subject has newly diagnosed AML and is eligible for intensive chemotherapy, and the compound is for use in combination with cytarabine plus daunorubicin or idarubicin (7+3 Regimen) . In an embodiment the subject has newly diagnosed NPM1-mutated (NPM1m) or KMT2A-rearranged (KMT2Ar) AML and is eligible for intensive chemotherapy, and the compound is for use in combination with cytarabine plus daunorubicin or idarubicin (7+3 Regimen) . In an embodiment, the subject has relapsed / refractory AML and is ineligible for intensive chemotherapy. In an embodiment the subject has relapsed / refractory AML and is eligible for intensive chemotherapy. The embodiments in this paragraph also apply to subgroups of AML.In a particular embodiment, embodiments described herein comprising the compound, venetoclax and azacytidine are for use in a method of treating relapsed / refractory acute leukemia. In a particular embodiment, other embodiments comprising the compound, venetoclax and azacytidine are for use in a method of treating relapsed / refractory AML or ALL or subgroups thereof. In a particular embodiment, other embodiments comprising the compound, venetoclax and azacytidine are for use in a method of treating relapsed / refractory AML or subgroups thereof (e.g. having NPM1 or KMT2A gene alterations) . In a particular embodiment, other embodiments comprising the compound, venetoclax and azacytidine are for use in a method of treating relapsed / refractory AML or subgroups thereof (e.g. having NPM1, KMT2A, NUP98 or NUP214 gene alterations) .In a particular embodiment, embodiments described herein comprising the compound, venetoclax and azacytidine are for use in a method of treating newly diagnosed acute leukemia in a subject ineligible for intensive chemotherapy. In a particular embodiment, other embodiments comprising the compound, venetoclax and azacytidine are for use in a method of treating newly diagnosed AML or ALL or subgroups thereof, in a subject ineligible for intensive chemotherapy. In a particular embodiment, other embodiments comprising the compound, venetoclax and azacytidine are for use in a method of treating newly diagnosed AML or subgroups thereof (e.g. having NPM1 or KMT2A gene alterations) , in a subject ineligible for intensive chemotherapy. In a particular embodiment, other embodiments comprising the compound, venetoclax and azacytidine are for use in a method of treating newly diagnosed AML or subgroups thereof (e.g. having NPM1, KMT2A, NUP98 or NUP214 gene alterations) , in a subject ineligible for intensive chemotherapy. In a particular embodiment, other embodiments comprising the compound, venetoclax and azacytidine are for use in a method of treating newly diagnosed AML or subgroups thereof (e.g. having NPM1-mutated (NPM1m) or KMT2A-rearranged (KMT2Ar) AML) , in a subject ineligible for intensive chemotherapy.In a particular embodiment, embodiments described herein comprising the compound and cytarabine plus daunorubicin or idarubicin (7+3 Regimen) are for use in a method of treating newly diagnosed acute leukemia in a subject eligible for intensive chemotherapy. In a particular embodiment, other embodiments comprising the compound and cytarabine plus daunorubicin or idarubicin (7+3 Regimen) are for use in a method of treating newly diagnosed AML or ALL or subgroups thereof, in a subject eligible for intensive chemotherapy. In a particular embodiment, other embodiments comprising the compound and cytarabine plus daunorubicin or idarubicin (7+3 Regimen) are for use in a method of treating newly diagnosed AML or subgroups thereof (e.g. having NPM1 or KMT2A gene alterations) , in a subject eligible for intensive chemotherapy. In a particular embodiment, other embodiments comprising the compound and cytarabine plus daunorubicin or idarubicin (7+3 Regimen) are for use in a method of treating newly diagnosed AML or subgroups thereof (e.g. having NPM1, KMT2A, NUP98 or NUP214 gene alterations) , in a subject eligible for intensive chemotherapy. In a particular embodiment, other embodiments comprising the compound and cytarabine plus daunorubicin or idarubicin (7+3 Regimen) are for use in a method of treating newly diagnosed AML or subgroups thereof (e.g. having NPM1-mutated (NPM1m) or KMT2A-rearranged (KMT2Ar) AML) , in a subject eligible for intensive chemotherapy.All embodiments, clauses and subgroups thereof, described herein for combinations for use in a method of treating cancer are also applicable for the method of treating cancer as such.All embodiments, clauses and subgroups thereof, described herein for a compound for use in combination with one or more additional therapeutic agents for use a method of treating cancer are also applicable for the method of treating cancer as such.All embodiments, clauses and subgroups thereof, described herein for combinations for use in a method of treating cancer are also applicable to the compound for use in said combinations for use in a method of treating cancer.All embodiments, clauses and subgroups thereof, described herein for a compound for use in combination with one or more additional therapeutic agents for use a method of treating cancer are also applicable to the combinations of a compound and one or more additional therapeutic agents for use in a method of treating cancer.All embodiments, clauses and subgroups thereof, described herein for combinations of a compound and one or more additional therapeutic agents for use in a method of treating cancer, are also applicable to a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer.All embodiments, clauses and subgroups thereof, described herein for a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer are also applicable to combinations of a compound and one or more additional therapeutic agents for use in a method of treating cancer.All embodiments, clauses and subgroups thereof, described herein for combinations of a compound and one or more additional therapeutic agents for use in a method of treating cancer, are also applicable to a method of treating cancer comprising administering to a subject in need thereof a combination of a compound and one or more additional therapeutic agents.All embodiments, clauses and subgroups thereof, described herein for a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer are also applicable to a method of treating cancer comprising administering to a subject in need thereof a compound for use in combination with one or more additional therapeutic agents.All embodiments, clauses and subgroups thereof, described herein for a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer are also applicable to a method of treating cancer comprising administering to a subject in need thereof a combination of a compound and one or more additional therapeutic agents.All embodiments, clauses and subgroups thereof, described herein for combinations of a compound and one or more additional therapeutic agents for use in a method of treating cancer, are also applicable to a method of treating cancer comprising administering to a subject in need thereof a compound and one or more additional therapeutic agents.All embodiments, clauses and subgroups thereof, described herein for a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer are also applicable to a method of treating cancer comprising administering to a subject in need thereof a compound and one or more additional therapeutic agents.All embodiments, clauses and subgroups thereof, described herein for combinations of a compound and one or more additional therapeutic agents for use in a method of treating cancer, are also applicable to a method of treating cancer comprising administering to a subject in need thereof a compound wherein the compound is administered in combination with one or more additional therapeutic agents.All embodiments, clauses and subgroups thereof, described herein for a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer, are also applicable to a method of treating cancer comprising administering to a subject in need thereof a compound wherein the compound is administered in combination with one or more additional therapeutic agents.All embodiments, clauses and subgroups thereof, described herein for a compound for use in combination with one or more additional therapeutic agents, are also applicable for the use of the compound in the manufacture of a dosage form for use with one or more additional therapeutic agents in one or more separate dosage forms.All embodiments, clauses and subgroups thereof, described herein for a compound for use in combination with one or more additional therapeutic agents for use in a method of treating cancer, are also applicable for the use of the compound in the manufacture of medicament for co-administration with one or more additional therapeutic agents for the treatment of cancer.All statements including the expression “for use in combination with” should also be considered to be included herein with the expression “for use in combination with” being replaced by the expression “is to be co-administered” (or "for use in co-administration with” ) .Thus as an example it should be clear that embodiments such as described below are also included herein:The present invention also provides a compound that is to be co-administered with a BCL-2 inhibitor and a hypomethylating agent for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound that is to be co-administered with a DNA intercalating agent and a pyrimidine analog for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.The present invention also provides a compound for use in co-administration with a FLT-3 inhibitor for use in a method of treating cancer,wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide, or a pharmaceutically acceptable salt or solvate thereof,wherein the compound is administered to a subject in need thereof in a dosage regimen comprising a target dosage period wherein the compound is administered at a target daily dosage of 60-400mg, wherein the daily dosage is calculated based on the free base form of the compound.All statements including the expression “for use in a method of treating cancer” should also be considered to be included herein with the expression “for use in a method of treating cancer” being replaced by the expression “for use in treating cancer” .In an embodiment, there is also provided a product comprising the compound and instructions for use, wherein the instructions for use describe one or more of the dosing regimens as described herein, and wherein the compound is (R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamide or a pharmaceutically acceptable salt or solvate thereofIt will be clear that in the context of this invention, all additional therapeutic agents referred to herein are intended to include the pharmaceutically acceptable salts and solvates thereof, any subgroup thereof or any combination of pharmaceutically acceptable salts and solvates thereof.It will be clear that in the context of this invention, references to venetoclax, azacytidine, decitabine, daunorubicin, doxorubicin, cytarabine, idarubicin, sorafenib, sunitinib, midostaurin (PKC412) , lestaurtinib (CEP-701) , tandutinib (MLN518) , quizartinib (AC220) , gilteritinib (ASP2215) , and KW-2449, also include the pharmaceutically acceptable salts and solvates thereof including any subgroup thereof or any combination of pharmaceutically acceptable salts and solvates thereof. For example, gilteritinib may be used as a fumarate salt.As mentioned before, it is understood that even when the term "about" is not used explicitly for dose amounts, every quantity given herein is meant to refer to the actual given value, and it is also meant to refer to the approximation to such given value that would reasonably be inferred based on the ordinary skill in the art, including approximations due to the experimental and / or measurement conditions for such given value.A combination of(R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamideor a pharmaceutically acceptable salt or solvate thereof;and a FLT-3 inhibitor, a DNA intercalating agent and a pyrimidine analog.(R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamideor a pharmaceutically acceptable salt or solvate thereof;for use in combination with a FLT-3 inhibitor, a DNA intercalating agent and a pyrimidine analog.A combination of(R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2-methoxyethyl) (methyl) amino) -2-methylhexan-3-yl) -2, 6-diazaspiro [3.4] octan-6-yl) -1, 2, 4-triazin-6-yl) oxy) benzamideor a pharmaceutically acceptable salt or solvate thereof;and a FLT-3 inhibitor, BCL-2 inhibitor, and a hypomethylating agent.(R) -N-ethyl-5-fluoro-N-isopropyl-2- ( (5- (2- (6- ( (2...
Claims
1. A compound for use in a method of treating cancer, which is (R)-N-ethyl-5-fluoro-N-isopropyl-2-((5-(2-(6-((2-methoxyethyl)(methyl)amino)-2-methylhexan-3-yl)-2,6-diazaspiro[3.4]octan-6-yl)-1,2,4-triazin-6-yl)oxy)benzamide or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof with a dosing regimen that includes a target dose period, wherein the compound is administered at a target daily dose of 60-400 mg, wherein the daily dose is calculated based on the free base form of the compound.
2. A compound for use according to claim 1, which is administered to a subject with an administration regimen comprising: (i) the initial dosing period in which the compound is administered at the initial daily dose; (ii) optionally a step-up period in which the compound is administered in a step-up daily dose, the step-up daily dose being greater than the initial daily dose; and (iii) a target dose period in which the compound is administered at a target daily dose of 60-400 mg, wherein the target dose level is greater than the initial daily dose and the step daily dose, if present, with all daily doses calculated based on the free base form of the compound.
3. A compound for use according to any one of claims 1, 2, wherein the target daily dose is 180-320 mg, in particular wherein the target daily dose is 200-300 mg.
4. A compound for use according to any one of paragraphs. 1, 2, wherein the target daily dose is provided by administering a dose of 100-200 mg twice a day (2 times a day).
5. A compound for use according to any one of claims 1, 2, wherein the target daily dose is achieved by administering a dose of 80-120 mg 2 times a day.
6. A compound for use according to one of claims 1-3, wherein the target daily dose is achieved by administering a dose of 100 mg 2 times a day or 150 mg 2 times a day.
7. A compound for use according to any of the preceding claims, wherein the administration regimen comprises an initial daily dose of 50-110 mg.
8. A compound for use according to any one of the preceding claims, wherein the administration regimen comprises an initial daily dose that is provided by administering a dose twice daily (2 times a day).
9. A compound for use according to any of the preceding claims, wherein the target daily dose is achieved by administering the dose twice daily (b.i.d.).
10. A compound for use according to any of the preceding claims, wherein the administration regimen comprises: (i) a starting dosing period in which the compound is administered at an initial daily dose of 60-100 mg delivered by twice daily (bid) administration of a dose of 30-50 mg bid; (ii) optionally a step-up period in which the compound is administered in a step-up daily dose, the step-up daily dose being 120-200 mg delivered by twice daily (bid) administration of a dose of 60-100 mg bid; and (iii) a target dose period in which the compound is administered at a target daily dose of 120-300 mg delivered by twice daily (bid) dosing of 60-150 mg bid, wherein the target dose level is greater than the step daily dose, if present.
11. A compound for use according to any of the preceding claims, wherein the administration regimen comprises: (A) (i) a starting dosing period in which the compound is administered at an initial daily dose of 60-100 mg delivered by twice daily (bid) administration of a dose of 30-50 mg bid; (ii) a step-up period in which the compound is administered in a step-up daily dose, the step-up daily dose being 120-200 mg delivered by twice daily (bid) administration of a dose of 60-100 mg bid; and (iii) a target dose period in which the compound is administered at a target daily dose of 120-300 mg delivered by twice daily (bid) dosing of 60-150 mg bid, wherein the target dose level is greater than the step daily dose, if present; or (B) (i) a starting dosing period in which the compound is administered at an initial daily dose of 60-100 mg delivered by twice daily (bid) administration of a dose of 30-50 mg bid; (ii) a target dose period in which the compound is administered at a target daily dose of 120-300 mg delivered by twice daily (bid) administration of a dose of 60-150 mg bid.
12. A compound for use according to any one of claims 1 to 11, wherein the initial dosing period is at least 7 days.
13. A compound for use according to claim 1, which is administered to a subject in need thereof with an administration regimen comprising (i) a 14-day initial dosing period in which the compound is administered at an initial daily dose of 100 mg, delivered by twice daily (bid) administration of 50 mg bid; (ii) a target dose period in which the compound is administered at a target daily dose of 200 mg delivered by twice daily (bid) administration of 100 mg bid.
14. A compound for use according to any of the preceding claims, which is administered as monotherapy.
15. A compound for use according to claim 1, intended for use in combination with one or more additional therapeutic agents.
16. A compound for use according to claim 15, wherein the one or more additional therapeutic agents comprise a BCL-2 inhibitor and a hypomethylating agent.
17. A compound for use according to claim 15, wherein the one or more additional therapeutic agents comprise a DNA intercalating agent and a pyrimidine analogue.
18. A compound for use according to claim 15, wherein the one or more additional therapeutic agents comprise a FLT-3 inhibitor and optionally a BCL-2 inhibitor.
19. A compound for use according to any one of claims 15-18, wherein the target daily dose is 180-320 mg.
20. A compound for use according to any one of claims 14-18, wherein the target daily dose is achieved by administering the dose twice a day (2 times a day).
21. A compound for use according to any one of claims 15-18, wherein the target daily dose is achieved by administering a dose of 100-200 mg 2 times a day.
22. A compound for use according to any one of claims 15-18, wherein the target daily dose is achieved by administering a dose of 80-120 mg 2 times a day.
23. A compound for use according to any one of claims 15-18, wherein the target daily dose is achieved by administering a dose of 100 mg 2 times a day or 150 mg 2 times a day.
24. A compound for use according to any one of claims 15-23, wherein administration of the compound begins on day 4 after the start of the administration regimen and is performed at the target daily dose.
25. A compound for use according to any one of claims 15-23, wherein administration of the compound is commenced on day 4 (+3-day window) after the start of the administration regimen and is performed at the target daily dose.
26. A compound for use according to any one of claims 15-23, wherein the target dose administration period begins at least 3 days after the start of the administration regimen.
27. A compound for use according to any one of the preceding claims which is the bis-besylate salt of (R)-N-ethyl-5-fluoro-N-isopropyl-2-((5-(2-(6-((2-methoxyethyl)(methyl)amino)-2-methylhexan-3-yl)-2,6-diazaspiro[3.4]octan-6-yl)-1,2,4-triazin-6-yl)oxy)benzamide or a solvate thereof.
28. A compound for use according to any one of the preceding claims, which is a hydrate of the bis-besylate salt of (R)-N-ethyl-5-fluoro-N-isopropyl-2-((5-(2-(6-((2-methoxyethyl)(methyl)amino)-2-methylhexan-3-yl)-2,6-diazaspiro[3.4]octan-6-yl)-1,2,4-triazin-6-yl)oxy)benzamide.
29. A compound for use according to any of the preceding claims that is administered orally.
30. A connection for use according to any of the preceding claims, wherein: the compound is provided in a tablet dosage form for oral administration; the tablet dosage form comprises a tablet composition comprising the compound and a pharmaceutically acceptable carrier; and the tablet composition contains the compound at a loading of 10% w / w to 30% w / w calculated on the basis of the free base form relative to the total weight of the tablet composition.
31. A compound for use according to any one of the preceding claims, wherein the cancer is acute leukemia.
32. A compound for use according to claim 31, wherein the acute leukemia is acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL).
33. A compound for use according to claim 31 or 32, wherein the acute leukemia is refractory / relapsed.
34. A compound for use according to any one of claims 31-33, wherein the acute leukemia has an NPM1 alteration, a KMT2A alteration, a nucleoporin 98 (NUP98) gene alteration, or a nucleoporin 214 (NUP214) gene alteration.
35. A compound for use according to claim 34, wherein the acute leukemia carries KMT2A rearrangements or NPM1 mutations.
36. A compound for use according to any one of claims 34-35, wherein the leukemia is a leukemia having one or more associated mutations, wherein optionally the one or more associated mutations are selected from FLT3, DNMT3A, NRAS, TP53, KRAS, TET2, IDH2, IDH1, WT1, ASXL1, SRSF2, PPM1D, MEN1 and RAD21 mutations.
37. A compound for use according to any one of the preceding claims, wherein the subject is a subject who has previously undergone treatment for leukemia, optionally having previously undergone a stem cell transplant and / or previously undergone therapy with venetoclax.
38. A method of treating cancer comprising administering to a subject in need thereof a compound which is (R)-N-ethyl-5-fluoro-N-isopropyl-2-((5-(2-(6-((2-methoxyethyl)(methyl)amino)-2-methylhexan-3-yl)-2,6-diazaspiro[3.4]octan-6-yl)-1,2,4-triazin-6-yl)oxy)benzamide or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof with a dosing regimen that includes a target dose period, wherein the compound is administered at a target daily dose of 60-400 mg, wherein the daily dose is calculated based on the free base form of the compound.
39. A method of treating cancer comprising administering to a subject in need thereof a compound comprising (R)-N-ethyl-5-fluoro-N-isopropyl-2- ((5-(2-(6-((2-methoxyethyl)(methyl)amino)-2-methylhexan-3-yl)-2,6-diazaspiro[3.4]octan-6-yl)-1,2,4-triazin-6-yl)oxy)benzamide or a pharmaceutically acceptable salt or solvate thereof, wherein the compound is administered to a subject in need thereof with a dosage regimen comprising: (i) the initial dosing period in which the compound is administered at the initial daily dose; (ii) optionally a step-up period in which the compound is administered in a step-up daily dose, the step-up daily dose being greater than the initial daily dose; and (iii) a target dose period in which the compound is administered at a target daily dose of 60-400 mg, 90-400 mg, 100-380 mg, 120-380 mg, 180-320 mg, 200-300 mg, 200 mg, 250 mg, or 300 mg, wherein the target dose level is greater than the initial daily dose and the step daily dose, if present, with all daily doses calculated based on the free base form of the compound.
40. The method according to claim 38 or 39, wherein the administration regimen, cancer and / or subject are defined as set forth in any of claims 1-37.
41. A tablet dosage form comprising a tablet composition, wherein the tablet composition comprises an active pharmaceutical ingredient and a pharmaceutically acceptable carrier, wherein the active pharmaceutical ingredient is a free salt of (R)-N-ethyl-5-fluoro-N-isopropyl-2-((5-(2-(6-((2-methoxyethyl)(methyl)amino)-2-methylhexan-3-yl)-2,6-diazaspiro[3.4]octan-6-yl)-1,2,4-triazin-6-yl)oxy)benzamide or a solvate thereof; wherein the tablet composition contains the active pharmaceutical ingredient at a loading of from 10% w / w to 30% w / w, calculated on the basis of the free base form relative to the total weight of the tablet composition.
42. The tablet dosage form according to claim 41, wherein the tablet composition comprises an active pharmaceutical ingredient, a glidant, a lubricant, a substance for improving tablet disintegration and a filler.
43. The tablet dosage form of claim 42, wherein the filler is selected from silicified microcrystalline cellulose (SMCC), microcrystalline cellulose (MCC), mannitol, lactose, dibasic calcium phosphate, isomalt, corn starch, pregelatinized starch and magnesium carbonate or a combination thereof; wherein the lubricant and glidant are selected from hydrogenated vegetable oils, magnesium stearate, stearic acid, sodium lauryl sulfate, magnesium lauryl sulfate, colloidal silicon dioxide, colloidal anhydrous silicon dioxide and talc or a combination thereof;and wherein the tablet disintegration improving agent is selected from microcrystalline cellulose, sodium croscarmellose, alginic acid, sodium alginate, crosprovidone, cellulose, agar and related gums, sodium starch glycolate, corn starch, potato starch, sodium starch glycolate, Veegum HV, methylcellulose, L-HPC (low-substituted hydroxypropyl cellulose), agar, bentonite, sodium carboxymethylcellulose, calcium carboxymethylcellulose, carboxymethylcellulose, alginic acid, guar gum, corn starch and pregelatinized starch or a combination thereof.
44. A tablet dosage form according to claims 41, 42 or 43, wherein the tablet composition contains the active pharmaceutical ingredient at a loading of from 18% w / w to 22% w / w calculated on the basis of the free base form relative to the total weight of the tablet composition.
45. The tablet dosage form of claim 44, wherein the tablet composition contains the active pharmaceutical ingredient at a loading of 20% w / w calculated on the basis of the free base form relative to the total weight of the tablet composition.
46. A tablet dosage form according to claim 42, wherein: the active pharmaceutical ingredient is the bis-besylate salt of (R)-N-ethyl-5-fluoro-N-isopropyl-2-((5-(2-(6-((2-methoxyethyl)(methyl)amino)-2-methylhexan-3-yl)-2,6-diazaspiro[3.4]octan-6-yl)-1,2,4-triazin-6-yl)oxy)benzamide or its hydrate; The tablet composition contains a total of 20% w / w of the active pharmaceutical ingredient (calculated based on the free base form), a total of 0.5% w / w of a glidant, a total of 1% w / w of a lubricant, a total of 5% w / w of a tablet disintegration improver based on the total weight of the tablet composition, and the remainder being filler; wherein the filler is silicified microcrystalline cellulose (SMCC), the glidant is anhydrous colloidal silicon dioxide, the lubricant is magnesium stearate, and the tablet disintegration improver is crospovidone.
47. A tablet dosage form according to any one of paragraphs 41-46, which is a coated tablet, wherein the coated tablet comprises a tablet composition and a coating.
48. A tablet dosage form according to any one of claims 41-47, wherein the tablet composition contains from about 30 mg to about 100 mg of active pharmaceutical ingredient calculated on a free base basis.
49. A capsule filling composition comprising an active pharmaceutical ingredient and a pharmaceutically acceptable carrier, wherein the active pharmaceutical ingredient is (R)-N-ethyl-5-fluoro-N-isopropyl-2-((5-(2-(6-((2-methoxyethyl)(methyl)amino)-2-methylhexan-3-yl)-2,6-diazaspiro[3.4]octan-6-yl)-1,2,4-triazin-6-yl)oxy)benzamide or a pharmaceutically acceptable salt or solvate thereof.
50. The capsule filling composition of claim 49, comprising an active pharmaceutical ingredient, a glidant, a lubricant, and a filler, wherein the filler is selected from silicified microcrystalline cellulose (SMCC), microcrystalline cellulose (MCC), mannitol, lactose, dibasic calcium phosphate, isomalt, corn starch, pregelatinized starch, magnesium carbonate, or a combination thereof; and wherein the lubricant and glidant are selected from hydrogenated vegetable oils, magnesium stearate, stearic acid, sodium lauryl sulfate, magnesium lauryl sulfate, colloidal silicon dioxide, colloidal anhydrous silicon dioxide, talc, or a combination thereof.
51. A capsule filling composition according to claim 49, comprising from 15% w / w to 18% w / w of the API (calculated based on the free base form), from 0.5% w / w to 2% w / w of a total of a glidant, from 0.5% w / w to 1.5% w / w of a total of lubricant relative to the total weight of the capsule filling composition and the rest is a filler, wherein the API is (R)-N-ethyl-5-fluoro-N-isopropyl-2-((5-(2-(6-((2-methoxyethyl)(methyl)amino)-2-methylhexan-3-yl)-2,6-diazaspiro[3,4]octan-6-yl)-1,2,4-triazin-6-yl)oxy)benzamide bis-besylate salt or its hydrate, the filler is silicified microcrystalline cellulose (SMCC), the lubricant is magnesium stearate, and the glidant is anhydrous colloidal silicon dioxide.
52. The capsule filling composition of claim 51, comprising 16.7% w / w API (calculated based on the free base form), a total of 1.5% w / w glidant, a total of 1% w / w lubricant based on the total weight of the capsule filling composition and the balance being filler.
53. A capsule filling composition according to claim 49, 50, 51 or 52, which does not contain crospovidone, sodium croscarmellose, sodium starch glycolate and low-substituted hydroxypropyl cellulose.