TriangleNCT04657081 · CITED IN SOURCE DOCUMENTS
Pharmacokinetics, Safety, and Efficacy of ASTX727 in Combination With Venetoclax in Acute Myeloid Leukemia (AML)
An NCI or FDA source cites this study. A citation does not establish that it applies to an individual diagnosis.
- Phase
- PHASE1, PHASE2
- Status at capture
- ACTIVE NOT RECRUITING
- Registry last update
- 2026-09-01
The Phase 1 portion of this study is a single-arm, open-label, multicenter, non-randomized interventional study to evaluate the pharmacokinetic (PK) interaction, safety, and efficacy of ASTX727 when given in combination with venetoclax for the treatment of newly diagnosed acute myeloid leukemia (AML) in adults who are age 75 years or older, or who have comorbidities that preclude use of intensive induction chemotherapy. The primary purpose of the study is to rule out drug-drug interactions between ASTX727 and venetoclax combination therapy by evaluating area under the curve (AUC) and maximum plasma concentration (Cmax) exposure. The Phase 2 portion of the study is to assess the efficacy of ASTX727 and venetoclax when given in combination and to evaluate potential PK interactions. Phase 2 will follow the same overall study design as Phase 1 and has two parts, Part A and Part B.
Open the original ClinicalTrials.gov record → · Download preserved record
What did the study report?
Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.
No posted result sections were captured. Registered plans do not establish that a treatment works.
Who could take part
- eligibility Criteria
- Inclusion Criteria: 1. Participant must be 18 years of age or older. 2. Histological confirmation of newly diagnosed AML by World Health Organization (WHO) 2016 criteria. 3. Projected life expectancy of at least 3 months. 4. Participants must be considered ineligible for intensive induction chemotherapy defined by the following: a) Age 75 years or older, or b) Age 18 to 74 years with at least one of the following comorbidities: i) Severe cardiac disorder (eg, congestive heart failure requiring treatment, ejection fraction ≤50%, or chronic stable angina), ii) Severe pulmonary disorder (eg, diffusing lung capacity for carbon monoxide DLCO ≤65% or forced expiratory volume in 1 second \[FEV1\] ≤65%), iii) Creatinine clearance ≥30 mL/min to \<45 mL/min, iv) Moderate hepatic impairment with total bilirubin \>1.5 to ≤3.0 × upper limit of normal (ULN), v) Phase 1: Eastern Cooperative Oncology Group (ECOG) Performance Status of 2 (participants with ECOG ≥3 are not eligible); Phase 2, Parts A and B: ECOG Performance Status of 2 or 3 (participants with ECOG 4 are not eligible). 5. Phase 1: ECOG Performance Status of 0-2; Phase 2, Parts A and B: ECOG 0-3. 6. Women of child-bearing potential (according to recommendations of the Clinical Trial Facilitation Group \[CTFG\]) must not be pregnant or breastfeeding and must have a negative pregnancy test at screening. 7. Participants and their partners with reproductive potential must agree to use a highly effective contraceptive measure during the study and for 3 months after the last dose of study treatment, including refraining from sperm donation. Effective contraception includes methods such as oral contraceptives or double-barrier method (eg, use of a condom AND diaphragm, with spermicide). 8. Capable of giving legally effective informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form and protocol, and willing to participate in the study. Exclusion Criteria: 1. History of myeloproliferative neoplasm including myelofibrosis, essential thrombocythemia, polycythemia vera, chronic myeloid leukemia with or without BCR-ABL1 translocation and AML with BCR-ABL1 translocation. 2. The following karyotype abnormalities: t(8;21), inv(16) or t(15;17), or other acute promyelocytic leukemia variants that remain sensitive to all-trans retinoic acid (ATRA) therapy. 3. Known active central nervous system involvement from AML. 4. Known human immunodeficiency virus (HIV) infection (due to potential drug-drug interactions between antiretroviral medications and venetoclax). Human immunodeficiency virus testing will be performed at Screening, only if indicated per local guidelines or institutional standards. 5. Known active hepatitis B or C infection (detectable viral load). Hepatitis B or C testing will be performed at Screening, only if indicated per local guidelines or institutional standards. 6. Severe hepatic impairment defined as: bilirubin \>1.5×upper limit of normal (ULN) for participants ≥75 years or \>3×ULN for participants \<75 years; or aspartate aminotransferase (AST)/serum glutamic oxaloacetic transaminase (SGOT) or alanine aminotransferase (ALT)/serum glutamic pyruvic transaminase (SGPT) \>3×ULN (unless considered to be due to leukemic organ involvement). 7. Severe renal impairment defined as: calculated creatinine clearance or glomerular filtration rate \<30 mL/min. 8. A malabsorption syndrome or other condition that precludes enteral route of administration. 9. Cardiovascular disability status of New York Heart Association Class \>2. Class 2 is defined as cardiac disease in which patients are comfortable at rest but ordinary physical activity results in fatigue, palpitations, dyspnea, or anginal pain. 10. Chronic respiratory disease that requires continuous oxygen, or significant history of renal, neurologic, psychiatric, endocrinologic, metabolic, immunologic, hepatic, cardiovascular disease, any other medical condition or known hypersensitivity to any of the study medications that in the opinion of the investigator would adversely affect his/her participating in this study. 11. Clinically significant uncontrolled systemic infection requiring therapy (viral, bacterial, or fungal). 12. History of other malignancies prior to study entry, with the exception of adequately treated in situ carcinoma of the breast or cervix uteri; localized basal cell carcinoma or squamous cell carcinoma of the skin; previous malignancy confined and surgically resected (or adequately treated and controlled with other modalities); and any early stage malignancy for which no definitive therapy is required. 13. White blood cell (WBC) count \>25,000/μL (Hydroxyurea treatment is permitted to meet this criterion). 14. Treatment with the following: a) A hypomethylating agent (azacitidine or decitabine), or venetoclax including prior treatment for myelodysplastic syndrome (MDS), b) Chimeric Antigen Receptor (CAR)-T cell therapy, c) Investigational therapies for MDS or AML. 15. Participants who cannot discontinue concomitant prophylactic antifungal therapy with CYP3A inhibitor activity or other concomitant medications with moderate or strong CYP3A inhibitor activity ≥7 days or 5 half-lives, whichever is greater, prior to cycle 1 day 1 (C1D1). 16. Participants who cannot discontinue concomitant drugs that are strong CYP3A or P-gp inhibitors ≥7 days or 5 half-lives, whichever is greater, prior to C1D1. 17. Participants who cannot avoid concomitant drugs known as moderate or strong CYP3A inducers. 18. Current participation in another research study requiring interventions such as drug therapy or study procedures. 19. Known or suspected hypersensitivity to decitabine, cedazuridine, venetoclax, or any of their excipients. 20. Known significant mental illness or other condition such as active alcohol or other substance abuse or addiction that, in the opinion of the investigator, predisposes the participant to high risk of noncompliance with the protocol. 21. Participants who consume grapefruit, grapefruit products, Seville oranges (including marmalade containing Seville oranges) or starfruit ≤7 days prior to C1D1.
- healthy Volunteers
- false
- minimum Age
- 18 Years
- sex
- ALL
- std Ages
- ADULT
- OLDER_ADULT
Treatment arms and interventions
- arm Groups
- description
- Cycle 1: ASTX727 according to a prescribed dosing regimen and venetoclax on day 1 (100 mg daily), day 2 (200 mg daily), and days 3-28 (400 mg daily) of a 28-day cycle. Cycle 2 and beyond: ASTX727 according to a prescribed dosing regimen and venetoclax on days 1-28 (400 mg daily) of a 28-day cycle.
- intervention Names
- Drug: Decitabine and Cedazuridine (ASTX727)
- Drug: Venetoclax
- label
- Oral administration of ASTX727 and Venetoclax combination
- type
- EXPERIMENTAL
- interventions
- arm Group Labels
- Oral administration of ASTX727 and Venetoclax combination
- description
- Route of administration: oral in the form of a tablet
- name
- Decitabine and Cedazuridine (ASTX727)
- other Names
- INQOVI
- type
- DRUG
- arm Group Labels
- Oral administration of ASTX727 and Venetoclax combination
- description
- Route of administration: oral in the form of a tablet
- name
- Venetoclax
- other Names
- Venclexta
- type
- DRUG
Study design
- allocation
- NA
- intervention Model
- SINGLE_GROUP
- masking Info
- masking
- NONE
- primary Purpose
- TREATMENT
Enrollment
- count
- 101
- type
- ACTUAL
Registered outcome plans (not posted results)
- primary Outcomes
- description
- Venetoclax area under the curve from time 0 to 24 hours (AUC0-24) with and without ASTX727 in Phase 1 and Phase 2, Part A.
- measure
- Pharmacokinetic parameter: AUC0-24
- time Frame
- On Days 5 and 15 in Cycle 2 (28 days per cycle)
- description
- Venetoclax maximum observed concentration (Cmax) with and without ASTX727 in Phase 1 and Phase 2, Part A.
- measure
- Pharmacokinetic parameter: Cmax
- time Frame
- On Days 5 and 15 in Cycle 2 (28 days per cycle)
- description
- Number of participants with CR in Phase 2, Parts A and B.
- measure
- Complete Response (CR)
- time Frame
- Up to 36 months
- secondary Outcomes
- description
- Decitabine and cedazuridine area under the curve from time 0 to 24 hours (AUC0-24) in Phase 1 and Phase 2, Parts A and B.
- measure
- Pharmacokinetic parameter: AUC0-24
- time Frame
- Cycle 1, 2 and 3 (28 days per cycle)
- description
- Decitabine and cedazuridine maximum observed concentration (Cmax) in Phase 1 and Phase 2, Parts A and B.
- measure
- Pharmacokinetic parameter: Cmax
- time Frame
- Cycle 1, 2 and 3 (28 days per cycle)
- description
- Decitabine and cedazuridine area under the curve from time 0 to 8 hours (AUC0-8) in Phase 1 and 2, Parts A and B.
- measure
- Pharmacokinetic parameter: AUC0-8
- time Frame
- Cycle 1, 2 and 3 (28 days per cycle)
- description
- Decitabine and cedazuridine area under the curve from time 0 to infinity (AUC0-inf) in Phase 2, Parts A and B.
- measure
- Pharmacokinetic parameter: AUC0-inf
- time Frame
- Cycle 1, 2 and 3 (28 days per cycle)
- description
- Decitabine 5-day cumulative AUC in Phase 1.
- measure
- Pharmacokinetic parameter: 5-day AUC
- time Frame
- Cycle 2 (28 days per cycle)
- description
- Number of participants with treatment-emergent adverse events (TEAEs) in Phase 1 and 2, Parts A and B.
- measure
- Safety: Participants with TEAEs
- time Frame
- Up to 36 months
- description
- Number of participants with CR (Phase 1), CR + complete response with partial hematological recovery (CRh), and CR + incomplete blood count recovery (CRi) in Phase 1 and 2, Parts A and B.
- measure
- Complete response (CR)
- time Frame
- Up to 36 months
- description
- Number of days from the first dose to the first documented evidence of complete response or CRh in Phase 1 and 2, Parts A and B.
- measure
- Time to Response
- time Frame
- Up to 36 months
- description
- Number of days from the start of response (CR or CRh) until disease progression, start of alternative antileukemia therapy, or death in Phase 1 and 2, Parts A and B.
- measure
- Duration of Response
- time Frame
- Up to 36 months
- description
- Number of days from date of first dose until death due to any cause in Phase 1 and 2, Parts A and B.
- measure
- Overall Survival
- time Frame
- Up to 36 months
- description
- Venetoclax, decitabine and cedazuridine minimum observed concentration (Cmin) in Phase 1 and Phase 2, Parts A and B.
- measure
- Pharmacokinetic parameter: Cmin
- time Frame
- Cycle 1, 2 and 3 (28 days per cycle)
- description
- Venetoclax, decitabine and cedazuridine time to maximum observed concentration in Phase 1 and Phase 2, Parts A and B.
- measure
- Pharmacokinetic parameter: Tmax
- time Frame
- Cycle 1, 2 and 3 (28 days per cycle)
Full study description
- brief Summary
- The Phase 1 portion of this study is a single-arm, open-label, multicenter, non-randomized interventional study to evaluate the pharmacokinetic (PK) interaction, safety, and efficacy of ASTX727 when given in combination with venetoclax for the treatment of newly diagnosed acute myeloid leukemia (AML) in adults who are age 75 years or older, or who have comorbidities that preclude use of intensive induction chemotherapy. The primary purpose of the study is to rule out drug-drug interactions between ASTX727 and venetoclax combination therapy by evaluating area under the curve (AUC) and maximum plasma concentration (Cmax) exposure. The Phase 2 portion of the study is to assess the efficacy of ASTX727 and venetoclax when given in combination and to evaluate potential PK interactions. Phase 2 will follow the same overall study design as Phase 1 and has two parts, Part A and Part B.
Source references
- references
- citation
- Roboz GJ, Zeidan AM, Mannis GN, Montesinos P, Arnan M, Savona MR, Odenike O, McCloskey JK, Amin HV, Fathi AT, Bernal Del Castillo T, Rodriguez-Macias G, Liesveld JL, Im AP, Cerny J, Gentile TC, Oganesian A, Chan D, Wan Y, Dijkstra M, Keer HN, Griffiths EA, DiNardo CD. All-Oral Treatment of Newly Diagnosed Acute Myeloid Leukemia. N Engl J Med. 2026 Jun 4;394(21):2107-2116. doi: 10.1056/NEJMoa2510223.
- pmid
- 42235013
- type
- DERIVED
Source notices and limitations
Discovery and provenance
- release id
- ctgov-registry-7ad944f6deaf1f5cd6122126
- edge id
- nct-edge-476a50bd3fbfbe2f5e6c
- requested nct id
- NCT04657081
- primary nct id
- NCT04657081
- source kind
- fda_approval_notice
- source record id
- fda-990c1df07ad6d6a2
- source file sha256
- ca480285ecc7b42c58ddc456518135088e43c1620cd41979403b9deb48e6b9f4
- payload sha256
- 890806252642c28064d8dfd69de0248aadff816d0282adbd8bdd3bb71fb1c433
- payload
- clinical indication matching status
- not_inferred
- end exclusive
- true
- id
- nct-edge-476a50bd3fbfbe2f5e6c
- link basis
- explicit_NCT_identifier_in_acquired_source
- nct id
- NCT04657081
- occurrences
- context exact
- "https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm">Drugs@FDA</a> . </p><h2>Efficacy and Safety</h2><p>Efficacy was evaluated in Study ASTX727-07 (NCT04657081), a single arm, open-label clinical trial of decitabine and cedazuridine tablets in combination with venetoclax in adults with newly diagnosed AML who were age
- end
- 25490
- exact text
- NCT04657081
- start
- 25479
- offset unit
- unicode_code_points
- source event date
- 2026-05-13
- source file
- /tmp/cancer-full-research/updates/pages/fda-approves-oral-combination-decitabine-and-cedazuridine-tablets-venetoclax-newly-diagnosed-acute.html
- source file sha256
- ca480285ecc7b42c58ddc456518135088e43c1620cd41979403b9deb48e6b9f4
- source json pointer
- Source null
- source kind
- fda_approval_notice
- source record id
- fda-990c1df07ad6d6a2
- source string basis
- UTF-8_text_with_universal_newline_translation
- source string sha256
- ca480285ecc7b42c58ddc456518135088e43c1620cd41979403b9deb48e6b9f4
- source title
- FDA approves oral combination of decitabine and cedazuridine tablets with venetoclax for newly diagnosed acute myeloid leukemia
- release id
- ctgov-registry-7ad944f6deaf1f5cd6122126
- edge id
- nct-edge-f0209dfdade1aed66c15
- requested nct id
- NCT04657081
- primary nct id
- NCT04657081
- source kind
- fda_spl_label
- source record id
- 130350a1-2b88-4253-99ea-9fbc0d066ea7
- source file sha256
- 0dba7a040bbbf460aa9f482c5b67c9f28f75fc9df775ee1e7b345b758f780e07
- payload sha256
- 620d0cbfc32a94f4db0021d0faa8a682950f1677e365d48ef985635cd6d401ce
- payload
- application numbers
- NDA212576
- clinical indication matching status
- not_inferred
- end exclusive
- true
- id
- nct-edge-f0209dfdade1aed66c15
- link basis
- explicit_NCT_identifier_in_acquired_source
- nct id
- NCT04657081
- occurrences
- context exact
- th Venetoclax for AML Study ASTX727-07 INQOVI in combination with venetoclax was evaluated in Study ASTX727-07, a single arm, open-label, interventional study (NCT04657081) that included 101 adult patients with newly diagnosed AML who were age 75 years or older, or had comorbidities that precluded the use of intensive induction c
- end
- 5749
- exact text
- NCT04657081
- start
- 5738
- offset unit
- unicode_code_points
- source file
- /tmp/cancer-full-research/indications/raw/labels-00000.json
- source file sha256
- 0dba7a040bbbf460aa9f482c5b67c9f28f75fc9df775ee1e7b345b758f780e07
- source json pointer
- /results/60/clinical_studies/0
- source kind
- fda_spl_label
- source record id
- 130350a1-2b88-4253-99ea-9fbc0d066ea7
- source string basis
- parsed_JSON_string_unmodified
- source string sha256
- 3accbc56c4ce14e5039d180095515d5c38d073e7a27e95ee817056203f290a22
- spl effective time
- 20260525
- spl set id
- 91a0f80b-f865-4d06-a40d-4d148d99ee71
Preserved source evidence · Not medical advice