Ascertaining QUAZARs: slow-motion and light-speed development of oral azacitidine and decitabine.
Jonathan FeldDouglas TremblayShyamala C NavadaLewis R SilvermanPublished in: Leukemia & lymphoma (2022)
Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are devastating diseases that frequently rely on the use of parenteral hypomethylating agents (HMAs), either as monotherapy or in combination, as first-line treatment for many patients. Two new oral HMAs, decitabine/cedazuridine (DC) for use in place of azacitidine or decitabine in MDS, and azacitidine (CC-486) for use as maintenance treatment in AML, were recently approved by the FDA. 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.
Keyphrases
- acute myeloid leukemia
- allogeneic hematopoietic stem cell transplantation
- phase iii
- open label
- end stage renal disease
- dendritic cells
- clinical trial
- ejection fraction
- combination therapy
- optical coherence tomography
- peritoneal dialysis
- prognostic factors
- acute lymphoblastic leukemia
- double blind
- replacement therapy