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DRUG CLASS:

DNA methylation inhibitor

5d
New trial
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BCL2 (B-cell CLL/lymphoma 2)
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Venclexta (venetoclax) • Iclusig (ponatinib) • azacitidine • Nailike (olverembatinib)
12d
Transformation of Severe Aplastic Anemia into Donor Cell Leukemia after Allogeneic Hematopoietic Stem Cell Transplantation: A Rare Case Report. (PubMed, Am J Case Rep)
The patient received 1 cycle of induction chemotherapy with azacytidine and achieved complete remission...CONCLUSIONS The mechanism of how normal donor hematopoietic cells transform to leukemia in the host remains unclear. Donor cell leukemia provides a unique opportunity to examine genetic variations in donors and hosts with regards to the progression to malignancy.
Journal
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HOXA11 (Homeobox A11)
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azacitidine
13d
New P1 trial
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azacitidine
18d
EVI-3: Combining Active and Passive DNA Hypomethylation (clinicaltrials.gov)
P2, N=196, Recruiting, Kirsten Grønbæk | Trial completion date: Sep 2027 --> Dec 2027 | Trial primary completion date: Sep 2024 --> Dec 2025
Trial completion date • Trial primary completion date • Combination therapy
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azacitidine
18d
Autophagy degrades immunogenic endogenous retroelements induced by 5-azacytidine in acute myeloid leukemia. (PubMed, Leukemia)
Finally, autophagy was associated with a lower abundance of CD8+ T-cell markers in AML patients expressing high levels of EREs. This work demonstrates that AZA-induced EREs are degraded by autophagy and shows that inhibiting autophagy can improve the immune recognition of AML blasts in treated patients.
Journal
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CD8 (cluster of differentiation 8)
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azacitidine
1m
COZMOS:Phase I/Ib Trial of Combined 5'Azacitidine and Carboplatin for Recurrent/Refractory Pediatric Brain/Solid Tumors (clinicaltrials.gov)
P1, N=31, Completed, The Hospital for Sick Children | Active, not recruiting --> Completed | Trial completion date: Jul 2022 --> Mar 2024
Trial completion • Trial completion date
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carboplatin • azacitidine
1m
Differential Gene Regulatory Network Analysis between Azacitidine-Sensitive and -Resistant Cell Lines. (PubMed, Int J Mol Sci)
Our results suggest that controlling the identified genes (e.g., the metallothionein gene family) and "cellular response"-related pathways ("cellular response to zinc ion", "cellular response to copper ion", and "cellular response to cadmium ion", where the enriched functional-related genes are MT2A, MT1F, MT1G, and MT1E) may provide crucial clues to address azacitidine resistance in patients with AML. We expect that our strategy will be a useful tool to uncover patient-specific molecular interplay that provides crucial clues for precision medicine in not only gastric cancer but also complex diseases.
Preclinical • Journal
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GRB7 (Growth Factor Receptor Bound Protein 7) • IL18 (Interleukin 18) • ELF3 (E74 Like ETS Transcription Factor 3) • MT2A (Metallothionein 2A)
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azacitidine
2ms
Piplartine eliminates CD34 + AML stem/progenitor cells by inducing oxidative stress and suppressing NF-κB signalling. (PubMed, Cell Death Discov)
Significantly, PL suppressed AML development in a mouse xenograft model, and its combination with current AML treatments (cytarabine, daunorubicin and azacytidine) had synergistic effects, indicating translational therapeutic potential. Taken together, these data position PL as a novel anti-AML candidate drug that can target leukaemia stem/progenitors and is amenable to combinatorial therapeutic strategies.
Journal
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CD34 (CD34 molecule)
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cytarabine • azacitidine • daunorubicin
2ms
Loss of Dnmt3a increased self-renewal and resistance to pegIFNα in JAK2-V617F-positive myeloproliferative neoplasms. (PubMed, Blood)
PegIFNα combined with 5-azacytidine only partially overcame resistance in VF;DmΔ/Δ mice. However, this combination strongly decreased the JAK2-mutant allele burden in mice carrying VF mutation only, showing potential to inflict substantial damage preferentially to the JAK2-mutant clone.
Journal
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DNMT3A (DNA methyltransferase 1) • JAK2 (Janus kinase 2) • IFNA1 (Interferon Alpha 1)
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DNMT3A mutation • JAK2 V617F • JAK2 mutation
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azacitidine
2ms
A case of Bloom syndrome manifesting with therapy-related myelodysplastic syndromes harboring a novel BLM gene variant. (PubMed, Int J Hematol)
She was initially treated with azacitidine for MDS and showed transient improvement, but eventually died at age of 35 due to progression of MDS. Genetic screening revealed compound heterozygous variants in the BLM gene, with a recurrent variant previously reported in BS in one allele and a previously unreported variant in the other allele. Based on her characteristic clinical features and the presence of heterozygous variants in the BLM gene, she was diagnosed with BS harboring compound heterozygous BLM variants.
Journal
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BLM (BLM RecQ Like Helicase)
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azacitidine
2ms
Cellular senescence gene TACC3 associated with colorectal cancer risk via genetic and DNA methylated alteration. (PubMed, Arch Toxicol)
The regulatory effects of gene, variant, and DNA methylation were explored through dual-luciferase and 5-azacytidine treatment experiments, complemented by multiple database analyses...In addition, subjects with high-TACC3 expression presented an immunosuppressive microenvironment. These findings provide insights into the involvement of genetic variants of cellular senescence genes in the development and progression of colorectal cancer.
Journal • Epigenetic controller
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TACC3 (Transforming acidic coiled-coil containing protein 3)
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TACC3 expression
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azacitidine
2ms
Sirolimus and Azacitidine in Treating Patients With High Risk Myelodysplastic Syndrome or Acute Myeloid Leukemia That is Recurrent or Not Eligible for Intensive Chemotherapy (clinicaltrials.gov)
P2, N=57, Active, not recruiting, Sidney Kimmel Cancer Center at Thomas Jefferson University | Trial completion date: Dec 2023 --> Apr 2028 | Trial primary completion date: Dec 2023 --> Apr 2028
Trial completion date • Trial primary completion date
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Chr del(7q)
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azacitidine • sirolimus
2ms
A 2-week treatment with 5-azacytidine improved the hypercontractility state in prostate from obese mice: Role of the nitric oxide-cyclic guanosine monophosphate signalling pathway. (PubMed, Clin Exp Pharmacol Physiol)
When prostates from obese mice treated with 5-AZA were incubated in vitro with inhibitors of the NOS or sGC, the inhibitory effect of 5-AZA was reverted, therefore, showing the involvement of NO and cGMP. In conclusion, our study paves the way to develop or repurpose therapies that recover the expression of eNOS and sGC and, hence, to improve prostate function in BPH.
Preclinical • Journal
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NOS3 (Nitric oxide synthase 3)
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azacitidine
2ms
Azacitidine-Hesperetin Combination Induces S-phase Cell Cycle Arrest and Apoptosis in Human Leukemia Cells. (PubMed, Anticancer Res)
Overall, our findings indicate that the Aza-Hes combination induces apoptosis and S-phase cell-cycle arrest through the mitogen-activated protein kinase pathway. In conclusion, the Aza-Hes combination is a potential antileukemia treatment.
Journal
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ANXA5 (Annexin A5) • MAPK8 (Mitogen-activated protein kinase 8)
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azacitidine
2ms
New P1 trial
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decitabine/ tetrahydrouridine (EPI01)
2ms
Computational insights into KRAS G12C inhibition: exploring possible repurposing of Azacitidine and Ribavirin. (PubMed, J Biomol Struct Dyn)
Additionally, % occupancies, bond angles and the length of hydrogen bonds were calculated. These findings suggest that Azacitidine and Ribavirin may potentially serve as candidates for repurposing in individuals with KRAS-dependent cancers.Communicated by Ramaswamy H. Sarma.
Journal
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KRAS (KRAS proto-oncogene GTPase)
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KRAS G12C • KRAS G12
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azacitidine • decitabine
2ms
New trial
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cytarabine • azacitidine • cyclophosphamide
2ms
Azacitidine induced lung injury: report and contemporary discussion on diagnosis and management. (PubMed, Front Oncol)
However, if it happens, it can be fatal, especially if not recognized and treated promptly. In this review, we aim to familiarize the reader with the presentation of azacitidine-induced lung injury, provide our suggested approach to management based on our experience and the current understanding of its mechanism, and review the literature of 20 case reports available on this topic.
Review • Journal
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BCL2 (B-cell CLL/lymphoma 2)
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azacitidine
3ms
Phase II Decitabine (DAC) Versus Azacitidine (AZA) in Myelodysplastic Syndrome (MDS) (clinicaltrials.gov)
P2, N=268, Active, not recruiting, M.D. Anderson Cancer Center | Trial completion date: Oct 2026 --> Oct 2027
Trial completion date
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azacitidine • decitabine
3ms
The Maintenance Treatment of "ITIVA" in AML Patients (clinicaltrials.gov)
P=N/A, N=130, Recruiting, Henan Cancer Hospital
New trial
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IL2 (Interleukin 2)
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azacitidine • thalidomide
3ms
Flow cytometry of DNMT1 as a biomarker of hypomethylating therapies. (PubMed, Cytometry B Clin Cytom)
The 5-azacytidine (AZA) and decitabine (DEC) are noncytotoxic, differentiation-inducing therapies approved for treatment of myelodysplastic syndrome, acute myeloid leukemias (AML), and under evaluation as maintenance therapy for AML postallogeneic hematopoietic stem cell transplant and to treat hemoglobinapathies. Analysis of patient samples demonstrated assay reproducibility, variation in patient DNMT1 levels prior to treatment, and DNMT1 depletion posttherapy. A flow-cytometry assay has been developed that in the research setting of clinical trials can inform studies of DEC or 5-AZA treatment to achieve targeted molecular pharmacodynamic effects and better understand treatment-resistance/failure.
Journal
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DNMT1 (DNA methyltransferase 1)
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azacitidine • decitabine
3ms
Anti-leukemic effect of azacitidine, a DNA methyltransferase inhibitor, on cell lines of myeloid leukemia associated with Down syndrome. (PubMed, Exp Hematol)
Moreover, the effect of AZA on normal hematopoiesis did not differ significantly between individuals with non-Down syndrome and Down syndrome. In summary, this study suggests that AZA is a potentially effective treatment option for ML-DS disease control, including relapsed cases, and has reduced side-effects.
Preclinical • Journal
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IFNAR2 (Interferon Alpha And Beta Receptor Subunit 2)
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azacitidine
3ms
DNA demethylation and tri-methylation of H3K4 at the TACSTD2 promoter are complementary players for TROP2 regulation in colorectal cancer cells. (PubMed, Sci Rep)
Treatment with 5-Azacytidine, a DNMT1 inhibitor, led to demethylation of the TACSTD2 promoter accompanied by an increase in TROP2 protein expression...Our data provide novel evidence for promoter demethylation and simultaneous gains of the active histone mark H3K4me3 across CpG-rich sequences, both being complementary mechanisms in the transcriptional regulation of TACSTD2 in colon cancer. The functional consequences of TROP2 loss in colorectal cancer needs to be further investigated.
Journal • Epigenetic controller
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TACSTD2 (Tumor Associated Calcium Signal Transducer 2)
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TROP2 expression • TROP2 overexpression
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azacitidine
3ms
The combination of SHOX2 and RASSF1A DNA methylation had a diagnostic value in pulmonary nodules and early lung cancer. (PubMed, Oncology)
The combination of SHOX2 and RASSF1A DNA methylation had a diagnostic value in pulmonary nodules and early LC. SHOX2 positively modulated the tumorigenesis and metastasis of LC by regulating DNA methylation processes.
Journal • Epigenetic controller
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RASSF1 (Ras Association Domain Family Member 1) • SHOX2 (SHOX Homeobox 2)
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RASSF1 methylation
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azacitidine
4ms
Artificial intelligence-based prediction models for acute myeloid leukemia using real-life data: A DATAML registry study. (PubMed, Leuk Res)
We designed artificial intelligence-based prediction models (AIPM) using 52 diagnostic variables from 3687 patients included in the DATAML registry treated with intensive chemotherapy (IC, N = 3030) or azacitidine (AZA, N = 657) for an acute myeloid leukemia (AML)...We believe that AIPM could help hematologists to deal with the huge amount of data available at diagnosis, enabling them to have an OS estimation and guide their treatment choice. Our registry-based AIPM could offer a large real-life dataset with original and exhaustive features and select a low number of diagnostic features with an equivalent accuracy of prediction, more appropriate to routine practice.
Journal
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KIT (KIT proto-oncogene, receptor tyrosine kinase) • NPM1 (Nucleophosmin 1) • ASXL1 (ASXL Transcriptional Regulator 1) • NCAM1 (Neural cell adhesion molecule 1) • ANPEP (Alanyl Aminopeptidase, Membrane) • MPO (Myeloperoxidase)
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NPM1 mutation • ASXL1 mutation • KIT expression • NPM1 expression
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azacitidine
4ms
Real-world Effectiveness of Azacitidine in Treatment-Naive Patients With Higher-risk Myelodysplastic Syndromes. (PubMed, Clin Lymphoma Myeloma Leuk)
Consistent with other studies, CRRs and median OS with AZA in treatment-naive patients with HR-MDS were low in this large, real-world cohort. Novel agents/combinations are urgently needed to improve these outcomes in HR-MDS.
Journal • Real-world evidence • Real-world effectiveness • Real-world
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TP53 (Tumor protein P53)
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TP53 mutation
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azacitidine
4ms
Effects of Black Raspberry Supplementation on Methylation Pathways in Vav-creAsxl1Tet2 Double Knockout Mice with Early-stage Myelodysplastic Syndrome. (PubMed, J Cancer Prev)
While hypomethylating agents such as azacitidine and decitabine, as well as stem cell transplants, have been delineated as favored treatments for MDS, not all patients are physiologically receptive to these treatments. This methylation profile may have implications for delaying the onset of MDS, prompting a need for in-depth investigation. Our results emphasize the importance of exploring whether an extended BRB intervention can effectively alter MDS risk and elucidate the relationship between BRB-induced methylation changes, thus further unlocking the potential benefits of BRBs for MDS patients.
Preclinical • Journal
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ASXL1 (ASXL Transcriptional Regulator 1) • TET2 (Tet Methylcytosine Dioxygenase 2)
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azacitidine • decitabine
4ms
Synergy and antagonism between azacitidine and FLT3 inhibitors. (PubMed, Comput Biol Med)
We sought to determine whether combination of azacitidine with a FLT3 inhibitor (gilteritinib, quizartinib, LT-850-166, FN-1501 or FF-10101) displayed synergy or antagonism. The results show that combinations that involved non-covalent FLT3 inhibitors, including the two clinically approved drugs gilteritinib and quizartinib were antagonistic. On the other hand combinations with the covalent inhibitor FF-10101 had some range of concentrations where synergy was observed.
Journal
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FLT3 (Fms-related tyrosine kinase 3)
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FLT3 mutation
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Xospata (gilteritinib) • azacitidine • Vanflyta (quizartinib) • FF-10101 • FN-1501
4ms
Azacitidine and Chimerism in MDS or AML Patients After Allogeneic Stem Cell Transplant (clinicaltrials.gov)
P2, N=43, Recruiting, Henry Ford Health System | Trial completion date: Feb 2025 --> Feb 2026
Trial completion date
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azacitidine
4ms
NCI-2021-13436: CC-486 and Nivolumab for the Treatment of Hodgkin Lymphoma Refractory to PD-1 Therapy or Relapsed (clinicaltrials.gov)
P1, N=33, Recruiting, City of Hope Medical Center | Trial completion date: Nov 2023 --> May 2025 | Trial primary completion date: Nov 2023 --> May 2025
Trial completion date • Trial primary completion date
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PD-L1 (Programmed death ligand 1)
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Opdivo (nivolumab) • Onureg (azacitidine oral)
4ms
Annonaceous acetogenins as promising DNA methylation inhibitors to prevent and treat leukemogenesis - an in silico approach. (PubMed, J Biomol Struct Dyn)
MD simulation results reveal that annonacin remains stable throughout the simulation time of 100 ns and also binds to the catalytic domain of DNMT1 protein. From the above results, it can be concluded that annonacin has the potential to inhibit the DNA methylation process and prevent leukemogenesis.Communicated by Ramaswamy H. Sarma.
Journal • Epigenetic controller
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DNMT3A (DNA methyltransferase 1) • DNMT1 (DNA methyltransferase 1) • DNMT3B (DNA Methyltransferase 3 Beta)
4ms
New P2 trial
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cyclophosphamide • Onureg (azacitidine oral)
4ms
Nintedanib and Azacitidine in Treating Participants With HOX Gene Overexpression Relapsed or Refractory Acute Myeloid Leukemia (clinicaltrials.gov)
P1, N=44, Active, not recruiting, Northwestern University | Recruiting --> Active, not recruiting | Trial completion date: Jan 2024 --> Jan 2027 | Trial primary completion date: Mar 2023 --> Dec 2025
Enrollment closed • Trial completion date • Trial primary completion date
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FLT3 (Fms-related tyrosine kinase 3) • KMT2A (Lysine Methyltransferase 2A) • CD34 (CD34 molecule) • HOXA9 (Homeobox A9) • FGF2 (Fibroblast Growth Factor 2)
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HOXA9 overexpression
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azacitidine • nintedanib
5ms
New P1/2 trial
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cytarabine • azacitidine • cyclophosphamide • vindesine
5ms
Frontline treatment options for higher-risk MDS: can we move past azacitidine? (PubMed, Hematology Am Soc Hematol Educ Program)
Notably, azacitidine + venetoclax, azacitidine + sabatolimab, and azacitidine + magrolimab have shown exciting results in large, single-arm studies and have completed accrual in placebo-controlled, double-blind studies with OS as a primary endpoint. We all eagerly await the results of these studies.
Journal
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TP53 (Tumor protein P53)
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TP53 mutation
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Venclexta (venetoclax) • azacitidine • magrolimab (GS-4721) • sabatolimab (MBG453)
5ms
AZA Combined With RCHOP in P53-mutated DLBCL. (clinicaltrials.gov)
P2, N=52, Recruiting, The First Affiliated Hospital of Xiamen University
New P2 trial • Combination therapy
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doxorubicin hydrochloride • azacitidine • cyclophosphamide • epirubicin
5ms
The Combination of Methioninase and Ethionine Exploits Methionine Addiction to Selectively Eradicate Osteosarcoma Cells and Not Normal Cells and Synergistically Down-regulates the Expression of C-MYC. (PubMed, Cancer Genomics Proteomics)
In the present study, we showed, for the first time, the synergistic combination efficacy of rMETase and ethionine on osteosarcoma cells in contrast to normal fibroblasts, which were relatively resistant. The combination of rMETase and ethionine down-regulated c-MYC expression in the cancer cells. The present results indicate the combination of rMETase and ethionine may reduce the malignancy of osteosarcoma cells and can be a potential future clinical strategy.
Journal
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MYC (V-myc avian myelocytomatosis viral oncogene homolog)
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MYC expression
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ONCase (recombinant methionine α, γ-lyase)
5ms
ASCENT1: Research Study Investigating How Well NDec Works in People With Sickle Cell Disease (clinicaltrials.gov)
P2, N=84, Recruiting, Novo Nordisk A/S | Trial primary completion date: Nov 2023 --> Oct 2024
Trial primary completion date
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hydroxyurea • decitabine/ tetrahydrouridine (EPI01)
5ms
Targeting DNA methylation in diabetic kidney disease: A new perspective. (PubMed, Life Sci)
Although drugs such as azacytidine and decitabine have been approved to target DNA methylation for diseases such as hematological malignancies, none have been approved for the treatment of DKD. This review has discussed the abnormal DNA methylation pattern and the kidney tissue-specific expression of critical genes involved in DKD onset and progression. Moreover, we also discuss the new possible therapeutic approach that can be exploited for treating DNA methylation aberrancy in a site-specific manner against DKD.
Review • Journal • Epigenetic controller
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SLC1A5 (Solute Carrier Family 1 Member 5) • IRS2 (Insulin receptor substrate 2)
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azacitidine • decitabine
5ms
MC2TCR: MAGE-C2 TCR T Cell Trial to Treat Melanoma and Head and Neck Cancer (clinicaltrials.gov)
P1/2, N=20, Recruiting, Erasmus Medical Center | Trial primary completion date: Dec 2022 --> Dec 2024
Trial primary completion date
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BRAF (B-raf proto-oncogene)
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azacitidine
5ms
CD155 on Multiple Myeloma Cells Is Epigenetically Regulated, Reduce Patients Survival and Compromises the Action of Novel Immunotherapies (ASH 2023)
In vitro treatment with azacytidine was performed to assess the active repression of CD155 expression by DNA methylation...Based on our results, novel immunotherapies focused on enhancing immune cytotoxicity will benefit from CD155/TIGIT axis blockade. These results warrant further investigation on CD155 as a biomarker and target for novel immunotherapies for MM and other malignancies.
Clinical • PD(L)-1 Biomarker • IO biomarker
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TIGIT (T Cell Immunoreceptor With Ig And ITIM Domains 2) • PVR (PVR Cell Adhesion Molecule)
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azacitidine