Clonal diversity plays a key role in poor therapeutic outcomes in acute myeloid leukemia (AML) and myeloproliferative neoplasm (MPN) patient.We reported that AML/MPN-associated somatic mutations, e.g., FLT3(ITD) and JAK2(V617F) accompanied by TET2mut and/or DNMT3Amut can be applied to track clonal sensitivity to PARP and Pol θ inhibitor.Fish plot anal. demon- strated staggering differences between the sensitivity of various clones to ATRi and to PARPi, ATMi and RAD52i.For example, three clones carrying EZH2(V679M) , EZH2(V679M) + TET2(L1721W) and EZH2(V679M) + TET2(L1721W) + FLT3(D835Y) were resistant to ATRi ( ~8%, 61% and 26% survivors, resp.) but more sensitive to PARPi ( ~4%, 33% and 12% survivors, resp.) and ATMi (~3%, 39% an d 15% survivors, resp.).Conversely, three other clones carrying EZH2(V679M) + TET2(L1721W) + RUNX1(D160Y) , EZH2(V679M) + TET2(L1721W) + RUNX1(D160Y) + EZH2(E54*), and EZH2(V679M) + TET2(L1721W) + RUNX1(D160Y) + EZH2(E54*) + BCOR1(R1334Tfs*32) + NRAS(G13R) were sensitive to ATRi (~1%, 2% and 0.5% survivors, resp.) while less responsive to PARPi (~4%, 44% and 1% survivors, resp.) and ATMi (~2%, 38% and 1% survivors, resp.).Based on this observation, we hypothesized that simultaneous treatment with ATRi + PARPi or ATRi + ATMi should result in elimination of numerous, if not all AML-MD2 clones.In agreement with this hypothesis, these drug combinations were 20-30x more effective in eliminating clonogenic growth of AML-MD2 cells when compared to individual inhibitors.Altogether, 'clonal attack' by the combinations of DSBR inhibitors revealed remarkable efficiency in simultaneous eradication of malignant clones from a cohort of AML and MPN patients.