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    DRUG:

    Inqovi (decitabine/cedazuridine)

    i
    Other names: ASTX727, ASTX 727, oral C-DEC, DEC-C
    Company:
    Otsuka
    Drug class:
    DNMT inhibitor, Cytidine deaminase inhibitor
    Related drugs:
    23h
    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)
    P1, N=24, Suspended, National Cancer Institute (NCI) | Recruiting --> Suspended
    Trial suspension • Metastases
    |
    HER-2 (Human epidermal growth factor receptor 2) • PD-L1 (Programmed death ligand 1) • ER (Estrogen receptor) • PGR (Progesterone receptor)
    |
    HER-2 negative
    |
    Keytruda (pembrolizumab) • paclitaxel • Inqovi (decitabine/cedazuridine)
    1d
    ETCTN: Testing the Combination of Belinostat and SGI-110 (Guadecitabine) or ASTX727 for the Treatment of Unresectable and Metastatic Conventional Chondrosarcoma (clinicaltrials.gov)
    P2, N=32, Active, not recruiting, National Cancer Institute (NCI) | Suspended --> Active, not recruiting
    Enrollment closed • Metastases
    |
    IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • IDH2 (Isocitrate Dehydrogenase (NADP(+)) 2)
    |
    Inqovi (decitabine/cedazuridine) • Beleodaq (belinostat) • guadecitabine (SGI-110)
    7d
    A dose determining trial to assess the recommended dose of ES-3000 and ASTX727 for patients with Myelodysplasia (ACTRN12621001713886)
    P1/2, N=32, Recruiting, Australasian Leukaemia and Lymphoma Group | Not yet recruiting --> Recruiting
    Enrollment open
    |
    Inqovi (decitabine/cedazuridine)
    14d
    Study to Evaluate the Pharmacokinetics and Safety of Oral Decitabine and Cedazuridine in Cancer Patients With Renal Impairment (clinicaltrials.gov)
    P1, N=18, Recruiting, Astex Pharmaceuticals, Inc. | Phase classification: P1b --> P1
    Phase classification
    |
    Inqovi (decitabine/cedazuridine)
    14d
    Study to Evaluate the Pharmacokinetics and Safety of Oral Decitabine and Cedazuridine in Cancer Patients With Hepatic Impairment (clinicaltrials.gov)
    P1, N=27, Recruiting, Astex Pharmaceuticals, Inc. | Phase classification: P1b --> P1
    Phase classification
    |
    Inqovi (decitabine/cedazuridine)
    14d
    Roll-over Study for Patients Who Have Completed a Prior Novartis-sponsored Sabatolimab (MBG453) Study and Are Judged by the Investigator to Benefit From Continued Treatment With Sabatolimab. (clinicaltrials.gov)
    P2, N=70, Recruiting, Novartis Pharmaceuticals | Trial completion date: Jun 2028 --> Feb 2028
    Trial completion date
    |
    Venclexta (venetoclax) • azacitidine • decitabine • spartalizumab (PDR001) • Inqovi (decitabine/cedazuridine) • sabatolimab (MBG453)
    16d
    Olaparib and ASTX727 in BRCA1/2- and Homologous Recombination Deficient (HRD)-Mutated Tumors (clinicaltrials.gov)
    P1, N=18, Recruiting, Pamela Munster | Not yet recruiting --> Recruiting
    Enrollment open
    |
    BRCA (Breast cancer early onset)
    |
    Lynparza (olaparib) • Inqovi (decitabine/cedazuridine)
    24d
    STIMULUS MDS-US : Sabatolimab Added to HMA in Higher Risk MDS (clinicaltrials.gov)
    P2, N=90, Recruiting, Novartis Pharmaceuticals | Trial completion date: Mar 2025 --> Jun 2024 | Trial primary completion date: Jan 2024 --> Sep 2023
    Trial completion date • Trial primary completion date
    |
    azacitidine • decitabine • Inqovi (decitabine/cedazuridine) • sabatolimab (MBG453)
    29d
    Phase 1 Trial of ASTX727 in Subjects With Lower-risk Myelodysplastic Syndromes (clinicaltrials.gov)
    P1, N=30, Active, not recruiting, Otsuka Pharmaceutical Co., Ltd. | Trial completion date: Dec 2023 --> Jan 2026 | Trial primary completion date: Dec 2023 --> Jan 2026
    Trial completion date • Trial primary completion date
    |
    Inqovi (decitabine/cedazuridine)
    1m
    ASTX727 and Nivolumab in Squamous Cell Carcinoma of the Head and Neck (clinicaltrials.gov)
    P1, N=15, Not yet recruiting, Case Comprehensive Cancer Center
    New P1 trial • Metastases
    |
    Opdivo (nivolumab) • Inqovi (decitabine/cedazuridine)
    1m
    SOHO State of the Art Updates and Next Questions: An Update on Higher Risk Myelodysplastic Syndromes. (PubMed, Clin Lymphoma Myeloma Leuk)
    There has been import of the IDH1 inhibitor ivosidenib, initially approved for AML; the Bcl-2 inhibitor venetoclax and liposomal daunorubicin/cytarabine (CPX-351) are under active investigation as well. Unfortunately, effective treatment of TP53-mutated disease remains elusive, though preliminary evidence suggests improved outcomes with oral decitabine/cedazuridine over parenteral hypomethylating agent monotherapy. Investigational agents with novel mechanisms of action may help expand the repertoire of treatment options for HR-MDS and trials continue to offer a hopeful therapeutic avenue for suitable patients.
    Review • Journal • IO biomarker
    |
    TP53 (Tumor protein P53) • IDH1 (Isocitrate dehydrogenase (NADP(+)) 1)
    |
    TP53 mutation
    |
    Venclexta (venetoclax) • Tibsovo (ivosidenib) • Vyxeos (cytarabine/daunorubicin liposomal formulation) • Inqovi (decitabine/cedazuridine)
    1m
    Pharmacokinetics, Safety, and Efficacy of ASTX727 in Combination With Venetoclax in Acute Myeloid Leukemia (AML) (clinicaltrials.gov)
    P1/2, N=188, Active, not recruiting, Astex Pharmaceuticals, Inc. | Recruiting --> Active, not recruiting
    Enrollment closed
    |
    Venclexta (venetoclax) • Inqovi (decitabine/cedazuridine)
    1m
    ASTX660-03: A Study of Tolinapant in Combination With Oral Decitabine/Cedazuridine and Oral Decitabine/Cedazuridine Alone in Participants With Relapsed/Refractory Peripheral T-cell Lymphoma (R/R PTCL) (clinicaltrials.gov)
    P1/2, N=132, Active, not recruiting, Astex Pharmaceuticals, Inc. | Recruiting --> Active, not recruiting
    Enrollment closed
    |
    Inqovi (decitabine/cedazuridine) • tolinapant (ASTX660)
    2ms
    ASTX727 in Recurrent/Progressive Non-enhancing IDH Mutant Gliomas (clinicaltrials.gov)
    P1, N=18, Recruiting, Massachusetts General Hospital | Trial completion date: May 2024 --> May 2025 | Trial primary completion date: May 2022 --> May 2024
    Trial completion date • Trial primary completion date
    |
    IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • IDH2 (Isocitrate Dehydrogenase (NADP(+)) 2)
    |
    IDH2 mutation
    |
    Inqovi (decitabine/cedazuridine)
    2ms
    Venetoclax in Combination With Decitabine and Cedazuridine for the Treatment of Relapsed or Refractory Acute Myeloid Leukemia (clinicaltrials.gov)
    P2, N=20, Active, not recruiting, M.D. Anderson Cancer Center | Recruiting --> Active, not recruiting
    Enrollment closed • Combination therapy
    |
    Venclexta (venetoclax) • Inqovi (decitabine/cedazuridine)
    2ms
    Avapritinib With Decitabine in Patients With SM-AHN (clinicaltrials.gov)
    P1, N=34, Recruiting, H. Lee Moffitt Cancer Center and Research Institute
    New P1 trial • Combination therapy
    |
    Ayvakit (avapritinib) • Inqovi (decitabine/cedazuridine)
    2ms
    Study of ASTX727 Plus Talazoparib in Patients With Triple Negative or Hormone Resistant/HER2-negative Metastatic Breast Cancer (clinicaltrials.gov)
    P1, N=34, Completed, Kathy Miller | Recruiting --> Completed | Trial completion date: Jul 2025 --> Mar 2024 | Trial primary completion date: Dec 2024 --> Jan 2024
    Trial completion • Trial completion date • Trial primary completion date • Metastases
    |
    HER-2 (Human epidermal growth factor receptor 2)
    |
    HER-2 negative
    |
    Talzenna (talazoparib) • Inqovi (decitabine/cedazuridine)
    2ms
    HyPeR: Combination Study of Guadecitabine/ASTX727 and Pembrolizumab (clinicaltrials.gov)
    P1, N=34, Recruiting, Royal Marsden NHS Foundation Trust | Active, not recruiting --> Recruiting
    Enrollment open • Combination therapy
    |
    MSI (Microsatellite instability)
    |
    MSI-H/dMMR
    |
    Keytruda (pembrolizumab) • Inqovi (decitabine/cedazuridine) • guadecitabine (SGI-110)
    2ms
    Entrectinib in Combination With ASTX727 for the Treatment of Relapsed/Refractory TP53 Mutated Acute Myeloid Leukemia (clinicaltrials.gov)
    P1, N=12, Recruiting, OHSU Knight Cancer Institute | Trial completion date: Oct 2024 --> Jun 2025 | Trial primary completion date: Apr 2024 --> Dec 2024
    Trial completion date • Trial primary completion date • Combination therapy
    |
    TP53 (Tumor protein P53) • RUNX1 (RUNX Family Transcription Factor 1) • MAPK1 (Mitogen-activated protein kinase 1) • NTRK (Neurotrophic receptor tyrosine kinase) • MAPK3 (Mitogen-Activated Protein Kinase 3)
    |
    TP53 mutation • NTRK expression
    |
    Rozlytrek (entrectinib) • Inqovi (decitabine/cedazuridine)
    2ms
    A Study Comparing Treatment Preference Between Oral Decitabine/Cedazuridine and Azacitidine in Myelodysplastic Syndrome, Low-Blast Acute Myeloid Leukemia, or Chronic Myelomonocytic Leukemia (clinicaltrials.gov)
    P3, N=42, Recruiting, Otsuka Australia Pharmaceutical Pty Ltd | Not yet recruiting --> Recruiting | Phase classification: P3b --> P3
    Enrollment open • Phase classification
    |
    Inqovi (decitabine/cedazuridine) • Onureg (azacitidine oral)
    2ms
    A Phase Ia/Ib Open-label, Multiple Dose, Study to Determine the Recommended Dose, Evaluate PKs, PDs, Safety, and Activity of Venetoclax in Combination With Oral Decitabine/Cedazuridine (ASTX727) in Pediatric Patients With Relapsed/Refractory Acute Myeloid Leukemia (AML) (clinicaltrials.gov)
    P1, N=58, Recruiting, M.D. Anderson Cancer Center | Not yet recruiting --> Recruiting
    Enrollment open • Combination therapy
    |
    Venclexta (venetoclax) • Inqovi (decitabine/cedazuridine)
    2ms
    Venetoclax in Combination With Decitabine and Cedazuridine for the Treatment of Relapsed or Refractory Acute Myeloid Leukemia (clinicaltrials.gov)
    P2, N=20, Recruiting, M.D. Anderson Cancer Center | Active, not recruiting --> Recruiting
    Enrollment open • Combination therapy
    |
    Venclexta (venetoclax) • Inqovi (decitabine/cedazuridine)
    2ms
    Oral decitabine and cedazuridine plus venetoclax for older or unfit patients with acute myeloid leukaemia: a phase 2 study. (PubMed, Lancet Haematol)
    ASTX727 plus venetoclax is an active fully oral regimen and safe in most older or unfit patients with acute myeloid leukaemia. Our findings should be confirmed in larger multicentric studies.
    P2 data • Journal
    |
    TP53 (Tumor protein P53)
    |
    TP53 mutation
    |
    Venclexta (venetoclax) • Inqovi (decitabine/cedazuridine)
    2ms
    A Phase I/II Trial to Assess the Efficacy and Toxicity of ASTX727 (Oral Decitabine/Cedazuridine) for the Treatment of Hematological Neoplasms After Allogeneic Stem Cell Transplantation (clinicaltrials.gov)
    P2, N=65, Not yet recruiting, M.D. Anderson Cancer Center
    New P2 trial
    |
    Inqovi (decitabine/cedazuridine)
    2ms
    KCP-8602-801: Study of the Safety, Tolerability and Efficacy of KPT-8602 in Participants With Relapsed/Refractory Cancer Indications (clinicaltrials.gov)
    P1/2, N=277, Active, not recruiting, Karyopharm Therapeutics Inc | Trial completion date: Aug 2024 --> Dec 2024
    Trial completion date
    |
    KRAS (KRAS proto-oncogene GTPase)
    |
    KRAS wild-type • RAS wild-type
    |
    abiraterone acetate • dexamethasone • Inqovi (decitabine/cedazuridine) • eltanexor (KPT-8602)
    2ms
    NCI-2021-00893: Decitabine/Cedazuridine and Venetoclax in Combination With Ivosidenib or Enasidenib for the Treatment of Relapsed or Refractory Acute Myeloid Leukemia (clinicaltrials.gov)
    P1/2, N=84, Recruiting, M.D. Anderson Cancer Center | Phase classification: P1b/2 --> P1/2
    Phase classification • Combination therapy
    |
    IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • IDH2 (Isocitrate Dehydrogenase (NADP(+)) 2)
    |
    IDH2 mutation
    |
    Venclexta (venetoclax) • Tibsovo (ivosidenib) • Idhifa (enasidenib) • Inqovi (decitabine/cedazuridine)
    3ms
    Phase I/II Study of a Combination of Decitabine and Cedazuridine (ASTX727) and ASTX029, an ERK Inhibitor, for Patients With RAS Pathway Mutant Myelodysplastic Syndromes and Myelodysplastic/Myeloproliferative Neoplasms (clinicaltrials.gov)
    P1/2, N=36, Not yet recruiting, M.D. Anderson Cancer Center
    New P1/2 trial
    |
    Inqovi (decitabine/cedazuridine) • ASTX029
    3ms
    Oral Decitabine (ASTX727) and Durvalumab in Recurrent and/or Metastatic Head and Neck Cancer Patients (clinicaltrials.gov)
    P1/2, N=13, Active, not recruiting, Massachusetts General Hospital | Trial primary completion date: Dec 2023 --> Jan 2025
    Trial primary completion date • Combination therapy • Metastases
    |
    Imfinzi (durvalumab) • Inqovi (decitabine/cedazuridine)
    3ms
    A Phase 1B/2A Trial of Combination of ASTX727 With ASTX029 in Acute Myeloid Leukemia (clinicaltrials.gov)
    P1/2, N=42, Suspended, M.D. Anderson Cancer Center | Phase classification: P1b/2a --> P1/2 | Not yet recruiting --> Suspended
    Phase classification • Trial suspension
    |
    KRAS (KRAS proto-oncogene GTPase) • NF1 (Neurofibromin 1) • PTPN11 (Protein Tyrosine Phosphatase Non-Receptor Type 11)
    |
    Inqovi (decitabine/cedazuridine) • ASTX029
    3ms
    A Phase 1B/2A Trial of Combination of ASTX727 With ASTX029 in Acute Myeloid Leukemia (clinicaltrials.gov)
    P1/2, N=42, Suspended, M.D. Anderson Cancer Center
    New P1/2 trial
    |
    KRAS (KRAS proto-oncogene GTPase) • NF1 (Neurofibromin 1) • PTPN11 (Protein Tyrosine Phosphatase Non-Receptor Type 11)
    |
    Inqovi (decitabine/cedazuridine) • ASTX029
    4ms
    Venetoclax Added to Fludarabine + Busulfan Prior to Transplant and to Maintenance Therapy for AML, MDS, and MDS/MPN (clinicaltrials.gov)
    P1, N=100, Recruiting, Jacqueline Garcia, MD | Trial completion date: Dec 2024 --> Feb 2026 | Trial primary completion date: Feb 2024 --> Feb 2025
    Trial completion date • Trial primary completion date • Combination therapy
    |
    KRAS (KRAS proto-oncogene GTPase) • TP53 (Tumor protein P53) • FLT3 (Fms-related tyrosine kinase 3) • ABL1 (ABL proto-oncogene 1) • NRAS (Neuroblastoma RAS viral oncogene homolog) • BCR (BCR Activator Of RhoGEF And GTPase) • BCL2 (B-cell CLL/lymphoma 2) • NPM1 (Nucleophosmin 1) • NF1 (Neurofibromin 1) • RUNX1 (RUNX Family Transcription Factor 1) • SF3B1 (Splicing Factor 3b Subunit 1) • ASXL1 (ASXL Transcriptional Regulator 1) • KMT2A (Lysine Methyltransferase 2A) • PTPN11 (Protein Tyrosine Phosphatase Non-Receptor Type 11) • SRSF2 (Serine and arginine rich splicing factor 2) • BCOR (BCL6 Corepressor) • U2AF1 (U2 Small Nuclear RNA Auxiliary Factor 1) • STAG2 (Stromal Antigen 2) • MECOM (MDS1 And EVI1 Complex Locus) • NUP214 (Nucleoporin 214) • GATA2 (GATA Binding Protein 2) • DEK (DEK Proto-Oncogene) • RIT1 (Ras Like Without CAAX 1) • ZRSR2 (Zinc Finger CCCH-Type, RNA Binding Motif And Serine/Arginine Rich 2)
    |
    TP53 mutation • KRAS mutation • NRAS mutation • RUNX1 mutation • RAS mutation • ASXL1 mutation • CBL mutation • MLL rearrangement • U2AF1 mutation • Chr del(5q) • FLT3 wild-type
    |
    Venclexta (venetoclax) • azacitidine • Inqovi (decitabine/cedazuridine) • fludarabine IV • busulfan
    4ms
    Decitabine and Cedazuridine in Combination With Venetoclax for the Treatment of Patients Who Have Relapsed Acute Myeloid Leukemia After Donor Stem Cell Transplant (clinicaltrials.gov)
    P2, N=51, Recruiting, Sanjay Mohan | Trial completion date: Dec 2028 --> Mar 2029 | Initiation date: Dec 2023 --> Mar 2024 | Trial primary completion date: Dec 2027 --> Mar 2028
    Trial completion date • Trial initiation date • Trial primary completion date • Combination therapy
    |
    Venclexta (venetoclax) • Inqovi (decitabine/cedazuridine)
    4ms
    Decitabine/Cedazuridine (INQOVI), an Oral DNA Demethylating Agent, in Subjects With BAP1 Cancer Predisposition Syndrome and Subclinical, Early-Stage Mesothelioma (clinicaltrials.gov)
    P2, N=15, Recruiting, National Cancer Institute (NCI) | Not yet recruiting --> Recruiting
    Enrollment open
    |
    BAP1 (BRCA1 Associated Protein 1)
    |
    BAP1 mutation
    |
    Inqovi (decitabine/cedazuridine)
    4ms
    Dose-Escalation Study of E7727, an Oral Cytidine Deaminase Inhibitor With Oral Decitabine in Subjects With Solid Tumors (clinicaltrials.gov)
    P1, N=29, Active, not recruiting, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Recruiting --> Active, not recruiting | Trial completion date: Dec 2023 --> Dec 2024
    Enrollment closed • Trial completion date
    |
    decitabine • Inqovi (decitabine/cedazuridine)
    4ms
    A Phase Ia/Ib Open-label, Multiple Dose, Study to Determine the Recommended Dose, Evaluate PKs, PDs, Safety, and Activity of Venetoclax in Combination With Oral Decitabine/Cedazuridine (ASTX727) in Pediatric Patients With Relapsed/Refractory Acute Myeloid Leukemia (AML) (clinicaltrials.gov)
    P1, N=58, Not yet recruiting, M.D. Anderson Cancer Center
    New P1 trial • Combination therapy
    |
    Venclexta (venetoclax) • Inqovi (decitabine/cedazuridine)
    4ms
    ETCTN: Testing the Combination of Belinostat and SGI-110 (Guadecitabine) or ASTX727 for the Treatment of Unresectable and Metastatic Conventional Chondrosarcoma (clinicaltrials.gov)
    P2, N=32, Suspended, National Cancer Institute (NCI) | Trial completion date: Jan 2024 --> Jan 2025 | Trial primary completion date: Jan 2024 --> Jan 2025
    Trial completion date • Trial primary completion date • Metastases
    |
    IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • IDH2 (Isocitrate Dehydrogenase (NADP(+)) 2)
    |
    Inqovi (decitabine/cedazuridine) • Beleodaq (belinostat) • guadecitabine (SGI-110)
    5ms
    Decitabine and Cedazuridine in Combination With Venetoclax for the Treatment of Patients Who Have Relapsed Acute Myeloid Leukemia After Donor Stem Cell Transplant (clinicaltrials.gov)
    P2, N=51, Recruiting, Sanjay Mohan
    Trial completion date • Trial primary completion date • Combination therapy
    |
    Venclexta (venetoclax) • Inqovi (decitabine/cedazuridine)
    5ms
    NCI-2021-02246: Testing Oral Decitabine and Cedazuridine (ASTX727) in Combination With Venetoclax for Higher-Risk Acute Myeloid Leukemia Patients (clinicaltrials.gov)
    P1/2, N=55, Active, not recruiting, National Cancer Institute (NCI) | Recruiting --> Active, not recruiting
    Enrollment closed • Combination therapy • Tumor mutational burden
    |
    BCL2 (B-cell CLL/lymphoma 2)
    |
    Venclexta (venetoclax) • cytarabine • daunorubicin • Inqovi (decitabine/cedazuridine) • Starasid (cytarabine ocfosfate)
    5ms
    Olaparib and ASTX727 in BRCA1/2- and Homologous Recombination Deficient (HRD)-Mutated Tumors (clinicaltrials.gov)
    P1, N=18, Not yet recruiting, Pamela Munster
    New P1 trial
    |
    BRCA (Breast cancer early onset)
    |
    Lynparza (olaparib) • Inqovi (decitabine/cedazuridine)
    5ms
    Study of ASTX727 Plus Talazoparib in Patients With Triple Negative or Hormone Resistant/HER2-negative Metastatic Breast Cancer (clinicaltrials.gov)
    P1, N=38, Recruiting, Kathy Miller | Trial completion date: Jul 2024 --> Jul 2025 | Trial primary completion date: Dec 2023 --> Dec 2024
    Trial completion date • Trial primary completion date • Metastases
    |
    HER-2 (Human epidermal growth factor receptor 2)
    |
    HER-2 negative
    |
    Talzenna (talazoparib) • Inqovi (decitabine/cedazuridine)
    6ms
    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)
    P1, N=24, Recruiting, National Cancer Institute (NCI) | Initiation date: Feb 2024 --> Sep 2023
    Trial initiation date • Metastases
    |
    HER-2 (Human epidermal growth factor receptor 2) • PD-L1 (Programmed death ligand 1) • ER (Estrogen receptor) • PGR (Progesterone receptor)
    |
    HER-2 negative
    |
    Keytruda (pembrolizumab) • paclitaxel • Inqovi (decitabine/cedazuridine)
    6ms
    Phase 3b Study Design for a Comparison of Treatment Preference between Oral Decitabine/Cedazuridine and Azacitidine in Adult Patients with IPSS-R Intermediate Myelodysplastic Syndrome, IPSS Intermediate-2 or High-Risk Myelodysplastic Syndrome, Low-Blast Acute Myeloid Leukaemia, or Chronic Myelomonocytic Leukaemia (ASH 2023)
    Descriptive statistics including frequencies, proportions, mean, standard deviation, median, and interquartile range will be used to summarize the study data. When complete, this study will address an evidence gap in the comparison of patient preference for oral decitabine/cedazuridine and SC AZA, and subsequently inform the value of oral decitabine/cedazuridine for the treatment of MDS, LB-AML and CMML.
    Clinical • P3 data
    |
    Inqovi (decitabine/cedazuridine)