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Testing the Addition of an IDH2 Inhibitor, Enasidenib, to Usual Treatment (Cedazuridine-Decitabine) for Higher-Risk Myelodysplastic Syndrome (MDS) With IDH2 Mutation (A MyeloMATCH Treatment Trial)

  • PhasePhase 2
  • StatusRecruiting
  • Planned enrollment54 people
  • Recruiting US sites143
  • SponsorNational Cancer Institute (NCI)
  • RegistryNCT06577441

Recruitment re-checked on ClinicalTrials.gov Oct 30, 2026. Public record; not medical advice.

Testing the Addition of an IDH2 Inhibitor, Enasidenib, to Usual Treatment (Cedazuridine-Decitabine) for Higher-Risk Myelodysplastic Syndrome (MDS) With IDH2 Mutation (A MyeloMATCH Treatment Trial): a one-minute explainerNCT065774411 min

Eligibility

Who can join

The film gives the main points. The full list below is copied from the registry; the study team makes the final decision.

  • Age18 Years to no maximum
  • SexAll
  • Healthy volunteersNo

You may be able to join if

  • GENERAL MYLEOMATCH REGISTRATION CRITERIA:
  • Patients must be registered to the Master Screening and Reassessment Protocol (MYELOMATCH) and assigned to this protocol by the MATCHBox Treatment Verification Team.
  • Participants must not have received prior anti-cancer therapy for AML or MDS.
  • Note: Hydroxyurea to control the white blood cell count (WBC) is allowed.
  • Note: Prior erythroid stimulating agent (ESA) is not considered prior therapy for the purposes of eligibility.
  • Participants must not be currently receiving any cytarabine-containing therapy other than up to 1 g/m^2 of cytarabine, which is allowed for urgent cytoreduction. The use of prior hydroxyurea, all-trans retinoic acid (ATRA), BCR-ABL directed tyrosine kinase inhibitor, erythropoiesis-stimulating agent, thrombopoietin receptor agonist and lenalidomide is allowed
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Patients must have a morphologically-confirmed diagnosis of MDS with a Revised International Prognostic Scoring System (IPSS-R) score ≥ 4.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Patients must have a detectable pathogenic IDH2 mutation based on the National Cancer Institute (NCI) Myeloid Panel.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): No prior treatment with deoxyribonucleic acid (DNA) methyltransferase inhibitors (ASTX727, azacitidine, or decitabine).
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Prior treatment with growth factors (ESA, granulocyte colony-stimulating factor [g-CSF], thrombopoietin [TPO] agonist) or luspatercept is allowed.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Prior treatment with lenalidomide with a maximum limit of 1 month of exposure is allowed.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Patients with therapy-related MDS are allowed.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Age ≥ 18 years.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Total bilirubin ≤ 1.5 x upper limit of normal (ULN)
  • Unless elevated due to Gilbert's syndrome. In patients with Gilbert's syndrome, if the total bilirubin is ≤ 3.0 x ULN, then they are eligible for enrollment.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamic-pyruvic transaminase [SGPT]) ≤ 3.0 x upper limit of normal (ULN).
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Creatinine clearance ≥ 30 mL/min
  • To be calculated using Cockroft Gault formula.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Not pregnant and not nursing, because this study involves: an agent that has known genotoxic, mutagenic and teratogenic effects.
  • Therefore, for women of childbearing potential only, a negative pregnancy test done as part of screening lab work prior to registration is required.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months prior to registration are eligible for this trial.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated.
  • REGISTRATION ELIGIBILITY CRITERIA (STEP 1): Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load.
  • RE-REGISTRATION ELIGIBILITY CRITERIA (STEP 2): Patients on the ASTX727 monotherapy arm (Regimen 1) that do not achieve a CR (complete response), CRL (CR with limited count recovery), or CRh (CR with partial count recovery) after completing 6 cycles of study treatment.
  • RE-REGISTRATION ELIGIBILITY CRITERIA (STEP 2): ECOG performance status ≤ 2.
  • RE-REGISTRATION ELIGIBILITY CRITERIA (STEP 2): Total bilirubin ≤ 1.5 x upper limit of normal (ULN).
  • Unless elevated due to Gilbert's syndrome. In patients with Gilbert's syndrome if the total bilirubin is ≤ 3.0 x ULN, then they are eligible for enrollment.
  • RE-REGISTRATION ELIGIBILITY CRITERIA (STEP 2): AST (SGOT)/ALT (SGPT) ≤ 3.0 x upper limit of normal (ULN)
  • RE-REGISTRATION ELIGIBILITY CRITERIA (STEP 2): Creatinine clearance ≥ 30 mL/min
  • To be calculated using Cockroft Gault formula.
  • RE-REGISTRATION ELIGIBILITY CRITERIA (STEP 2): Not pregnant and not nursing, because this study involves: an agent that has known genotoxic, mutagenic and teratogenic effects.

The treatment

How it is intended to work

This is how the treatment is meant to work. Whether it helps, and how safe it is, is what this trial is testing.

enasidenib mesylate. The mesylate salt form of enasidenib, an orally available inhibitor of specific mutant forms of the mitochondrial enzyme isocitrate dehydrogenase type 2 (IDH2), with potential antineoplastic activity. Upon administration, enasidenib specifically inhibits various mutant forms of IDH2, including the IDH2 variants R140Q, R172S, and R172K, which inhibits the formation of 2-hydroxyglutarate (2HG). This may lead to both an induction of cellular differentiation and an inhibition of cellular proliferation in IDH2-expressing tumor cells. IDH2, an enzyme in the citric acid cycle, is mutated in a variety of cancers; it initiates and drives cancer growth by blocking differentiation and the production of the oncometabolite 2HG. NCI Drug Dictionary

Treatments listed in the registry

  • Biospecimen Collection (Procedure): Undergo buccal swab and blood sample collection
  • Bone Marrow Aspiration (Procedure): Undergo bone marrow aspiration
  • Bone Marrow Biopsy (Procedure): Undergo bone marrow biopsy
  • Decitabine and Cedazuridine (Drug): Given PO
  • Enasidenib (Drug): Given PO

The study

Treatment groups

Randomized · Parallel · masking: None

Regimen 1 (ASTX727) (Active Comparator)

Patients receive ASTX727 PO QD on days 1-5 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients who do not achieve a CR, CRL, or CRh at the end of cycle 6 may cross-over to Regimen 2. Patients who experience CR, PR, or SD any time after 4 cycles of treatment may be reassessed in order to go to a higher myeloMATCH tier assignment or to TAP. Patients also undergo bone marrow biopsy and aspiration throughout the study. Patients may also undergo optional buccal swab on study, and/or optional additional bone marrow aspiration and blood sample collection on study and at disease progression.

Regimen 2 (ASTX727, enasidenib) (Experimental)

Patients receive ASTX727 PO QD on days 1-5 and enasidenib PO QD on days 1-28 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients who experience CR, PR, or SD any time after 4 cycles of treatment may be reassessed in order to go to a higher myeloMATCH tier assignment or to TAP. Patients also undergo bone marrow biopsy and aspiration throughout the study. Patients may also undergo optional buccal swab on study, and/or optional additional bone marrow aspiration and blood sample collection on study and at disease progression.

What it involves

Procedures

As the registry describes them. Requirements to join, such as a tissue sample, are in the eligibility list above even when on-study procedures are optional. Ask the study team which steps apply to you.

  • biopsy: Part of the study plan
  • bone marrow: Part of the study plan; some time points described as optional
  • blood samples: Part of the study plan; some time points described as optional

Goals

What the study measures

Main goals

  • Complete response (CR) rate (Up to 4 cycles of treatment)

Other goals

  • Event-free survival (EFS)
  • Overall survival (OS)
  • Time to response
  • Duration of response
  • Incidence of adverse events
  • Change in IDH2 variant allele frequency (VAF)
  • Allogeneic stem cell transplantation rate
  • Measurable residual disease rate
  • Cytogenetic and molecular features
  • Time to transformation of myelodysplastic syndrome to acute myeloid leukemia (AML)

Planned enrollment: 54 (estimated).

Where

Recruiting US sites

  • UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care, Irvine, California
  • UC Irvine Health/Chao Family Comprehensive Cancer Center, Orange, California
  • UF Health Cancer Institute - Gainesville, Gainesville, Florida
  • Miami Cancer Institute, Miami, Florida
  • Memorial Hospital West, Pembroke Pines, Florida
  • Phoebe Putney Memorial Hospital, Albany, Georgia
  • Saint Luke's Cancer Institute - Boise, Boise, Idaho
  • Kootenai Health - Coeur d'Alene, Coeur d'Alene, Idaho
  • Saint Luke's Cancer Institute - Fruitland, Fruitland, Idaho
  • Saint Luke's Cancer Institute - Meridian, Meridian, Idaho
  • Saint Alphonsus Cancer Care Center-Nampa, Nampa, Idaho
  • Saint Luke's Cancer Institute - Nampa, Nampa, Idaho
  • Kootenai Clinic Cancer Services - Post Falls, Post Falls, Idaho
  • Kootenai Clinic Cancer Services - Sandpoint, Sandpoint, Idaho
  • Illinois CancerCare-Bloomington, Bloomington, Illinois
  • Illinois CancerCare-Canton, Canton, Illinois
  • Illinois CancerCare-Carthage, Carthage, Illinois
  • Northwestern University, Chicago, Illinois
  • Swedish Covenant Hospital, Chicago, Illinois
  • University of Chicago Comprehensive Cancer Center, Chicago, Illinois
  • Carle at The Riverfront, Danville, Illinois
  • Cancer Care Specialists of Illinois - Decatur, Decatur, Illinois
  • Decatur Memorial Hospital, Decatur, Illinois
  • Northwestern Medicine Cancer Center Kishwaukee, DeKalb, Illinois
  • Illinois CancerCare-Dixon, Dixon, Illinois
  • Carle Physician Group-Effingham, Effingham, Illinois
  • Crossroads Cancer Center, Effingham, Illinois
  • Illinois CancerCare-Eureka, Eureka, Illinois
  • NorthShore University HealthSystem-Evanston Hospital, Evanston, Illinois
  • Illinois CancerCare-Galesburg, Galesburg, Illinois
  • Northwestern Medicine Cancer Center Delnor, Geneva, Illinois
  • NorthShore University HealthSystem-Glenbrook Hospital, Glenview, Illinois
  • Northwestern Medicine Glenview Outpatient Center, Glenview, Illinois
  • Northwestern Medicine Grayslake Outpatient Center, Grayslake, Illinois
  • NorthShore University HealthSystem-Highland Park Hospital, Highland Park, Illinois
  • Edward Hines Jr VA Hospital, Hines, Illinois
  • Illinois CancerCare-Kewanee Clinic, Kewanee, Illinois
  • Northwestern Medicine Lake Forest Hospital, Lake Forest, Illinois
  • Illinois CancerCare-Macomb, Macomb, Illinois
  • Carle Physician Group-Mattoon/Charleston, Mattoon, Illinois
  • Loyola University Medical Center, Maywood, Illinois
  • UC Comprehensive Cancer Center at Silver Cross, New Lenox, Illinois
  • Cancer Care Center of O'Fallon, O'Fallon, Illinois
  • HSHS Saint Elizabeth's Hospital, O'Fallon, Illinois
  • Northwestern Medicine Orland Park, Orland Park, Illinois
  • University of Chicago Medicine-Orland Park, Orland Park, Illinois
  • Illinois CancerCare-Ottawa Clinic, Ottawa, Illinois
  • Illinois CancerCare-Pekin, Pekin, Illinois
  • Illinois CancerCare-Peoria, Peoria, Illinois
  • Illinois CancerCare-Peru, Peru, Illinois
  • Illinois CancerCare-Princeton, Princeton, Illinois
  • Southern Illinois University School of Medicine, Springfield, Illinois
  • Springfield Clinic, Springfield, Illinois
  • Springfield Memorial Hospital, Springfield, Illinois
  • Carle Cancer Center, Urbana, Illinois
  • Northwestern Medicine Cancer Center Warrenville, Warrenville, Illinois
  • Illinois CancerCare - Washington, Washington, Illinois
  • UChicago Medicine Northwest Indiana, Crown Point, Indiana
  • UI Health Care Mission Cancer and Blood - Ankeny Clinic, Ankeny, Iowa
  • UI Health Care Mission Cancer and Blood - West Des Moines Clinic, Clive, Iowa
  • Iowa Methodist Medical Center, Des Moines, Iowa
  • UI Health Care Mission Cancer and Blood - Des Moines Clinic, Des Moines, Iowa
  • Mercy Medical Center - Des Moines, Des Moines, Iowa
  • UI Health Care Mission Cancer and Blood - Laurel Clinic, Des Moines, Iowa
  • University of Iowa/Holden Comprehensive Cancer Center, Iowa City, Iowa
  • UI Healthcare Mission Cancer and Blood - Pella, Pella, Iowa
  • UI Health Care Mission Cancer and Blood - Waukee Clinic, Waukee, Iowa
  • University of Kansas Clinical Research Center, Fairway, Kansas
  • University of Kansas Cancer Center, Kansas City, Kansas
  • University of Kansas Hospital-Westwood Cancer Center, Westwood, Kansas
  • The James Graham Brown Cancer Center at University of Louisville, Louisville, Kentucky
  • UofL Health Medical Center Northeast, Louisville, Kentucky
  • LSU Health Baton Rouge-North Clinic, Baton Rouge, Louisiana
  • Our Lady of the Lake Physician Group, Baton Rouge, Louisiana
  • Our Lady of The Lake, Baton Rouge, Louisiana
  • Walter Reed National Military Medical Center, Bethesda, Maryland
  • Tufts Medical Center, Boston, Massachusetts
  • Trinity Health IHA Medical Group Hematology Oncology - Brighton, Brighton, Michigan
  • Trinity Health IHA Medical Group Hematology Oncology - Canton, Canton, Michigan
  • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital, Chelsea, Michigan
  • Cancer Hematology Centers - Flint, Flint, Michigan
  • Genesys Hurley Cancer Institute, Flint, Michigan
  • Trinity Health Saint Mary Mercy Livonia Hospital, Livonia, Michigan
  • Trinity Health Saint Joseph Mercy Oakland Hospital, Pontiac, Michigan
  • Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus, Ypsilanti, Michigan
  • Essentia Health Saint Joseph's Medical Center, Brainerd, Minnesota
  • Essentia Health - Deer River Clinic, Deer River, Minnesota
  • Essentia Health Cancer Center, Duluth, Minnesota
  • Minnesota Oncology - Edina, Edina, Minnesota
  • Essentia Health Hibbing Clinic, Hibbing, Minnesota
  • Abbott-Northwestern Hospital, Minneapolis, Minnesota
  • Hennepin County Medical Center, Minneapolis, Minnesota
  • Regions Hospital, Saint Paul, Minnesota
  • United Hospital, Saint Paul, Minnesota
  • Essentia Health Sandstone, Sandstone, Minnesota
  • Essentia Health Virginia Clinic, Virginia, Minnesota
  • Parkland Health Center - Farmington, Farmington, Missouri
  • Sainte Genevieve County Memorial Hospital, Sainte Genevieve, Missouri
  • Missouri Baptist Medical Center, St Louis, Missouri
  • Missouri Baptist Sullivan Hospital, Sullivan, Missouri
  • Community Hospital of Anaconda, Anaconda, Montana
  • Billings Clinic Cancer Center, Billings, Montana
  • Bozeman Health Deaconess Hospital, Bozeman, Montana
  • Benefis Sletten Cancer Institute, Great Falls, Montana
  • Logan Health Medical Center, Kalispell, Montana
  • Community Medical Center, Missoula, Montana
  • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center, Lebanon, New Hampshire
  • Cooperman Barnabas Medical Center, Livingston, New Jersey
  • Monmouth Medical Center, Long Branch, New Jersey
  • Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
  • Community Medical Center, Toms River, New Jersey
  • University of New Mexico Cancer Center, Albuquerque, New Mexico
  • Roswell Park Cancer Institute, Buffalo, New York
  • Stony Brook University Medical Center, Stony Brook, New York
  • Duke University Medical Center, Durham, North Carolina
  • East Carolina University, Greenville, North Carolina
  • Essentia Health Cancer Center-South University Clinic, Fargo, North Dakota
  • Ohio State University Comprehensive Cancer Center, Columbus, Ohio
  • University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
  • Geisinger Medical Center, Danville, Pennsylvania
  • UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania
  • Geisinger Wyoming Valley/Henry Cancer Center, Wilkes-Barre, Pennsylvania
  • Prisma Health Cancer Institute - Spartanburg, Boiling Springs, South Carolina
  • Prisma Health Cancer Institute - Easley, Easley, South Carolina
  • Prisma Health Cancer Institute - Butternut, Greenville, South Carolina
  • Prisma Health Cancer Institute - Faris, Greenville, South Carolina
  • Prisma Health Cancer Institute - Eastside, Greenville, South Carolina
  • Prisma Health Cancer Institute - Greer, Greer, South Carolina
  • Prisma Health Cancer Institute - Seneca, Seneca, South Carolina
  • Huntsman Cancer Institute/University of Utah, Salt Lake City, Utah
  • VCU Massey Comprehensive Cancer Center, Richmond, Virginia
  • Swedish Cancer Institute-Edmonds, Edmonds, Washington
  • Swedish Cancer Institute-Issaquah, Issaquah, Washington
  • Swedish Medical Center-First Hill, Seattle, Washington
  • Duluth Clinic Ashland, Ashland, Wisconsin
  • Saint Vincent Hospital Cancer Center Green Bay, Green Bay, Wisconsin
  • Saint Vincent Hospital Cancer Center at Saint Mary's, Green Bay, Wisconsin
  • Gundersen Lutheran Medical Center, La Crosse, Wisconsin
  • William S Middleton VA Medical Center, Madison, Wisconsin
  • Medical College of Wisconsin, Milwaukee, Wisconsin
  • Marshfield Medical Center-River Region at Stevens Point, Stevens Point, Wisconsin
  • Saint Vincent Hospital Cancer Center at Sturgeon Bay, Sturgeon Bay, Wisconsin
  • Marshfield Medical Center - Weston, Weston, Wisconsin

2 recruiting sites outside the US. Site status as of Oct 30, 2026. Check the live record before contacting a site.

Sources

Where this comes from

Registry record reviewed as fetched Oct 30, 2026, last updated by the sponsor Oct 25, 2026. Public record; not medical advice.

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