- |||||||||| Onureg (azacitidine oral) / BMS
Journal: Ascertaining QUAZARs: slow-motion and light-speed development of oral azacitidine and decitabine. (Pubmed Central) - Mar 24, 2023 We will discuss the development of these oral HMAs, including the advantages/disadvantages in transitioning to oral HMAs and an in depth look at the pivotal phase III trials that led to their FDA approval - ASCERTAIN for DC and QUAZAR-AML-001 for CC-486. We also review how these agents have been and are being studied in other malignancies, and examine the future role that these exciting novel agents will play in both MDS and AML.
- |||||||||| Venclexta (venetoclax) / Roche, AbbVie, Xospata (gilteritinib) / Astellas, Inqovi (decitabine/cedazuridine) / Otsuka
Trial completion date, Trial primary completion date: NCI-2021-06095: ASTX727, Venetoclax, and Gilteritinib for the Treatment of Newly Diagnosed, Relapsed or Refractory FLT3-Mutated Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndrome (clinicaltrials.gov) - Mar 16, 2023 P1/2, N=42, Recruiting, We also review how these agents have been and are being studied in other malignancies, and examine the future role that these exciting novel agents will play in both MDS and AML. Trial completion date: Jan 2023 --> Jan 2025 | Trial primary completion date: Jan 2023 --> Jan 2025
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD), Inqovi (decitabine/cedazuridine) / Otsuka
Enrollment open, Trial completion date, Trial primary completion date, Metastases: Testing the Addition of an Anti-cancer Drug, ASTX727 (Cedazuridine, Decitabine), to Chemotherapy (Paclitaxel) and Immunotherapy (Pembrolizumab) for Metastatic Triple-Negative Breast Cancer (clinicaltrials.gov) - Mar 16, 2023 P1, N=24, Recruiting, Trial completion date: Jan 2023 --> Jan 2025 | Trial primary completion date: Jan 2023 --> Jan 2025 Not yet recruiting --> Recruiting | Trial completion date: Oct 2024 --> Feb 2027 | Trial primary completion date: Oct 2024 --> Feb 2027
- |||||||||| imetelstat (GRN163L) / Geron, Reblozyl (luspatercept-aamt) / BMS, Merck (MSD), Inqovi (decitabine/cedazuridine) / Otsuka
Why the last? This chapter was written years ago, before the IPSS-M, before the 5th edition WHO, before the ICC, before important new biological and genetic discoveries, before luspatercept and ASTX727 approval, and potentially imetelstat soon. So it’s already partly obsolete. (Twitter) - Mar 4, 2023
- |||||||||| Imfinzi (durvalumab) / AstraZeneca, Inqovi (decitabine/cedazuridine) / Otsuka
Trial primary completion date, Combination therapy, Monotherapy, IO biomarker, Metastases: Oral Decitabine (ASTX727) and Durvalumab in Recurrent and/or Metastatic Head and Neck Cancer Patients (clinicaltrials.gov) - Feb 21, 2023 P1/2, N=13, Active, not recruiting, Trial completion date: Oct 2022 --> Oct 2023 | Trial primary completion date: Oct 2022 --> Oct 2023 Trial primary completion date: Jan 2023 --> Jul 2023
- |||||||||| Inqovi (decitabine/cedazuridine) / Otsuka
Journal: Reversible cardiomyopathy in a patient with chronic myelomonocytic leukemia treated with decitabine/cedazuridine: a case report. (Pubmed Central) - Jan 20, 2023 We present an occurrence of reversible cardiomyopathy in a patient who completed 5 cycles of decitabine/cedazuridine, an oral combination therapy developed to enhance oral bioavailability of decitabine thereby limiting its adverse effects. As the decitabine/cedazuridine combination therapy rises in popularity due to its convenient oral formulation, more trials are needed to understand the prevalence of cardiomyopathy with this drug and to discover preventative strategies for cardiotoxic effects.
- |||||||||| Venclexta (venetoclax) / Roche, AbbVie, Inqovi (decitabine/cedazuridine) / Otsuka
Trial completion date, Trial primary completion date, Combination therapy: Venetoclax and ASTX727 for the Treatment of Relapsed, Refractory, or Newly Diagnosed Acute Myeloid Leukemia (clinicaltrials.gov) - Dec 9, 2022 P2, N=40, Recruiting, No abstract available Trial completion date: Oct 2022 --> Oct 2023 | Trial primary completion date: Oct 2022 --> Oct 2023
- |||||||||| Inqovi (decitabine/cedazuridine) / Otsuka
Enrollment closed: ASTX727-03: Phase 1-2 Study of Low Dose ASTX727 (ASTX727 LD) in Lower Risk MDS (clinicaltrials.gov) - Nov 22, 2022 P1/2, N=160, Active, not recruiting, These data provided the rationale for a phase 1-2 study of the combination of tolinapant and oral decitabine/cedazuridine treatment in relapsed/refractory PTCL (NCT05403450). Recruiting --> Active, not recruiting
- |||||||||| Inqovi (decitabine/cedazuridine) / Otsuka
Prolonged Survival in Bi-Allelic TP53-Mutated (TP53mut) MDS Subjects Treated with Oral Decitabine/Cedazuridine in the Ascertain Trial (ASTX727-02) (ENMCC - 243-245) - Nov 4, 2022 - Abstract #ASH2022ASH_5242; The NGS mutational profile of MDS and CMML subjects in the ASCERTAIN trial included 35% with TP53mut and this group had a worse survival than those with WT TP53 apparently driven by the poor outcome of those with BA TP53mut. Further LOH studies will help refine this analysis, but in this conservative estimate, treatment with oral decitabine/cedazuridine in the ASCERTAIN study resulted in an estimated survival of 13 months for BA TP53mut which compares favorably with historical results.
- |||||||||| sabatolimab (MBG453) / Novartis
Stimulus MDS-US Trial in Progress: Evaluating Sabatolimab in Combination with Hypomethylating Agents (HMAs) in Patients with Intermediate-, High-, or Very High–Risk Myelodysplastic Syndrome (MDS) (ENMCC - Hall D) - Nov 4, 2022 - Abstract #ASH2022ASH_2631; P1b, P2 Primary end points are incidence and severity of adverse events (AEs) and serious AEs. Secondary endpoints are complete remission (CR) rate (according to International Working Group for the Prognosis for MDS), progression-free survival, overall survival, leukemia-free survival, percentage of patients with CR, marrow CR and/or partial remission, duration of CR, time to CR, and percentage of patients with improvement in red blood cell/platelet transfusion independence.
- |||||||||| ALLG AMLM26 Phase 1B/2 Study Investigating Novel Therapies to Target Early Relapse and Clonal Evolution As Pre-Emptive Therapy in AML (INTERCEPT): A Multi-Arm, Precision-Based, Recursive, Platform Trial (ENMCC - Hall D) - Nov 4, 2022 - Abstract #ASH2022ASH_2286;
Where no specific targeted treatment is available, patients will be randomly allocated to non-targeted therapies, if more than one applicable arm exists, to arms including sabatolimab, sabatolimab + azacitidine, ASTX727 + VEN or LDAC + VEN...Key secondary endpoints will be nadir MRD response, MRD clearance rate, median time to and duration of MRD response, relapse-free survival, overall survival and quality of life measures. Exploratory objectives will include analysis of drug resistance mechanisms and correlates of response.
- |||||||||| Inqovi (decitabine/cedazuridine) / Otsuka
Enrollment closed, Trial completion date: Ascertain: Study of ASTX727 vs IV Decitabine in MDS, CMML, and AML (clinicaltrials.gov) - Oct 10, 2022 P3, N=200, Active, not recruiting, Initiation date: Jun 2022 --> Oct 2022 Completed --> Active, not recruiting | Trial completion date: May 2022 --> Mar 2023
- |||||||||| Inqovi (decitabine/cedazuridine) / Otsuka
Enrollment closed, Combination therapy: Pharmacokinetics, Safety, and Efficacy of ASTX727 in Combination With Venetoclax in Acute Myeloid Leukemia (AML) (clinicaltrials.gov) - Oct 6, 2022 P1/2, N=124, Active, not recruiting, Completed --> Active, not recruiting | Trial completion date: May 2022 --> Mar 2023 Recruiting --> Active, not recruiting
- |||||||||| itacitinib (INCB039110) / Incyte, Inqovi (decitabine/cedazuridine) / Otsuka
Clinical, P1/2 data, Clinical Trial,Phase I, Clinical Trial,Phase II, Journal: The ABNL-MARRO 001 study: a phase 1-2 study of randomly allocated active myeloid target compound combinations in MDS/MPN overlap syndromes. (Pubmed Central) - Sep 29, 2022 P1/2 Recruiting --> Active, not recruiting Beyond the primary objectives of the study to evaluate the safety and efficacy of novel treatment combinations in MDS/MPN, the study will (i) Establish the ABNL MARRO infrastructure for future prospective studies, (ii) Forge innovative scientific research that will improve our understanding of pathogenetic mechanisms of disease, and (iii) Inform the clinical application of diagnostic criteria, risk stratification and prognostication tools, as well as response assessments in this heterogeneous patient population.
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