The FDA's approval of Inqovi (decitabine-cedazuridine) plus venetoclax for older or unfit AML patients marks a logistical advance in hypomethylating agent delivery, yet the supporting ASCERTAIN-V Phase II trial remains a single-arm study of roughly 101 participants showing a 41.6% complete remission rate without randomized controls or mature overall survival endpoints. This non-randomized design contrasts sharply with the VIALE-A RCT (NCT02993523, n=431) that established venetoclax-azacitidine superiority, where median OS reached 14.7 months versus 9.6 months with azacitidine alone, underscoring how observational-style Phase II data may overstate durability. Taiho's conflicts of interest as sponsor further warrant scrutiny of the unreached median CR duration and 8% fatality rate dominated by infections. Broader patterns in targeted oncology reveal this all-oral option could reduce infusion burden seen in prior parenteral regimens, yet missing long-term adherence metrics echo challenges from the earlier DEC10-VEN observational series (n=73) where real-world progression-free survival lagged trial figures by 20%. The coverage overlooks these gaps, focusing instead on convenience without contextualizing against larger evidence bases.