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DRUG:

Onureg (azacitidine oral)

i
Other names: CC 486, CC-486, BMS-986345, BMS986345, CC486, BMS 986345
Company:
BMS
Drug class:
DNMT inhibitor
12d
Enrollment open
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Onureg (azacitidine oral)
18d
Results from a Clinical Study of the All-Oral Regimen of CC-486 (Oral Azacitidine) and Venetoclax for Newly Diagnosed and Relapsed and Refractory Acute Myeloid Leukemia (ASH 2024)
Background: Venetoclax (ven) with azacitidine (aza) is the standard of care for newly diagnosed AML patients who are unfit for intensive induction chemotherapy. CC-486 (oral azacitidine) and ven is an all-oral regimen currently being investigated for the treatment of ND and R/R AML. The phase I portion of this study previously showed the MTD of CC-486 with ven to be 300mg d1-14 (Amaya et al. 2023).
Clinical
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TP53 (Tumor protein P53)
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TP53 mutation
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Venclexta (venetoclax) • Onureg (azacitidine oral)
1m
Trial completion date
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Onureg (azacitidine oral)
2ms
Oracle: Efficacy and Safety of Oral Azacitidine Compared to Investigator's Choice Therapy in Patients With Relapsed or Refractory AITL (clinicaltrials.gov)
P3, N=86, Active, not recruiting, The Lymphoma Academic Research Organisation | Trial completion date: Jun 2024 --> Dec 2024
Trial completion date
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PD-1 (Programmed cell death 1) • BCL6 (B-cell CLL/lymphoma 6) • CXCL13 (Chemokine (C-X-C motif) ligand 13) • ICOS (Inducible T Cell Costimulator) • MME (Membrane Metalloendopeptidase)
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PD-1 expression
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gemcitabine • bendamustine • Istodax (romidepsin) • Onureg (azacitidine oral)
2ms
GS-US-546-5920: Study of Magrolimab Combinations in Participants With Myeloid Malignancies (clinicaltrials.gov)
P2, N=54, Completed, Gilead Sciences | Trial primary completion date: Oct 2023 --> Mar 2024
Trial primary completion date
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Venclexta (venetoclax) • cytarabine • etoposide IV • mitoxantrone • magrolimab (ONO-7913) • Onureg (azacitidine oral)
2ms
Enrollment closed
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Onureg (azacitidine oral)
2ms
CC-486, Lenalidomide, and Obinutuzumab for the Treatment of Recurrent or Refractory CD20 Positive B-cell Lymphoma (clinicaltrials.gov)
P1, N=8, Active, not recruiting, Joseph Tuscano | Trial completion date: Dec 2024 --> Jul 2025 | Trial primary completion date: Apr 2024 --> Dec 2024
Trial completion date • Trial primary completion date
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CD20 (Membrane Spanning 4-Domains A1) • CD4 (CD4 Molecule)
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lenalidomide • Gazyva (obinutuzumab) • Onureg (azacitidine oral)
2ms
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, Active, not recruiting, City of Hope Medical Center | Recruiting --> Active, not recruiting
Enrollment closed
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PD-L1 (Programmed death ligand 1)
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Opdivo (nivolumab) • Onureg (azacitidine oral)
3ms
Maintenance Therapy in Acute Myeloid Leukemia. (PubMed, Am J Clin Oncol)
Hypomethylating agents like azacitidine and decitabine have shown promise in improving relapse-free and overall survival, particularly in older patients with AML ineligible for transplantation. Combination regimens involving azacitidine and venetoclax have demonstrated encouraging outcomes post-hematopoietic stem cell transplantation. Targeted therapies, particularly FLT3 inhibitors like midostaurin and quizartinib, have shown significant benefits in improving survival outcomes, especially in FLT3-mutated AML cases. Gilteritinib and sorafenib also exhibit the potential to reduce relapse rates post-transplant. Isocitrate dehydrogenase inhibitors, including ivosidenib and enasidenib, present novel options for postchemotherapy and posttransplantation maintenance...The approval of oral azacitidine represents a significant advancement, emphasizing the need for further investigation into personalized maintenance approaches. In conclusion, the evolving landscape of maintenance therapy and integrating targeted therapies in AML offers promising avenues for improving patient outcomes.
Journal • IO biomarker
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FLT3 (Fms-related tyrosine kinase 3) • WT1 (WT1 Transcription Factor)
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FLT3 mutation
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Venclexta (venetoclax) • sorafenib • Xospata (gilteritinib) • Rydapt (midostaurin) • Vanflyta (quizartinib) • decitabine • Tibsovo (ivosidenib) • Idhifa (enasidenib) • Onureg (azacitidine oral)
3ms
Trial completion • Trial completion date
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Onureg (azacitidine oral)
3ms
New trial
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Onureg (azacitidine oral)
5ms
REMAIN1: Oral Azacitidine in Transplant-Eligible Patients With Acute Myeloid Leukemia (AML) Suffering From Health-Inequality (clinicaltrials.gov)
P4, N=12, Not yet recruiting, Virginia Commonwealth University | Trial completion date: Oct 2028 --> Jan 2029 | Initiation date: Jun 2024 --> Sep 2024 | Trial primary completion date: Oct 2026 --> Jan 2027
Trial completion date • Trial initiation date • Trial primary completion date
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Onureg (azacitidine oral)
5ms
Enrollment change • Trial completion date
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PD-1 (Programmed cell death 1) • BCL6 (B-cell CLL/lymphoma 6) • CXCL13 (Chemokine (C-X-C motif) ligand 13) • ICOS (Inducible T Cell Costimulator) • MME (Membrane Metalloendopeptidase)
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gemcitabine • Istodax (romidepsin) • Onureg (azacitidine oral)
5ms
New P2 trial
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NPM1 (Nucleophosmin 1)
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Onureg (azacitidine oral) • vididencel (DCP-001)
6ms
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=13, Active, not recruiting, Otsuka Australia Pharmaceutical Pty Ltd | Recruiting --> Active, not recruiting | N=42 --> 13 | Trial primary completion date: Apr 2025 --> Jan 2025
Enrollment closed • Enrollment change • Trial primary completion date
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Inqovi (decitabine/cedazuridine) • Onureg (azacitidine oral)
6ms
Evaluating in Vivo AZA Incorporation in Mononuclear Cells Following Vidaza or CC486 (clinicaltrials.gov)
P2, N=40, Completed, Kirby Institute | Active, not recruiting --> Completed | N=60 --> 40
Trial completion • Enrollment change
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Onureg (azacitidine oral)
6ms
Oral azacitidine compared with standard therapy in patients with relapsed or refractory follicular helper T-cell lymphoma (ORACLE): an open-label randomised, phase 3 study. (PubMed, Lancet Haematol)
Although the pre-specified primary outcome of the trial was not met, the favourable safety profile suggests that azacitidine could add to the treatment options in these difficult to treat diseases especially in combination with other drugs. Trials with combination are in preparation in a platform trial.
Clinical • P3 data • Clinical Trial,Phase III • Journal • PD(L)-1 Biomarker • IO biomarker
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PD-1 (Programmed cell death 1) • BCL6 (B-cell CLL/lymphoma 6) • CXCL13 (Chemokine (C-X-C motif) ligand 13) • ICOS (Inducible T Cell Costimulator) • MME (Membrane Metalloendopeptidase)
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gemcitabine • bendamustine • Istodax (romidepsin) • Onureg (azacitidine oral)
6ms
A Dose-Finding and Efficacy Study of Venetoclax, CC-486, and Obinutuzumab in Follicular Lymphoma (clinicaltrials.gov)
P1/2, N=2, Terminated, University of Chicago | Completed --> Terminated; funding
Trial termination
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Venclexta (venetoclax) • Gazyva (obinutuzumab) • Onureg (azacitidine oral)
6ms
AMADEUS: Randomised Study of Oral Azacitidine vs Placebo Maintenance in AML or MDS Patients After Allo-SCT (clinicaltrials.gov)
P3, N=326, Active, not recruiting, University of Birmingham | Recruiting --> Active, not recruiting | Trial primary completion date: Apr 2024 --> Apr 2025
Enrollment closed • Trial primary completion date
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HLA-DRB1 (Major Histocompatibility Complex, Class II, DR Beta 1)
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Onureg (azacitidine oral)
7ms
FLO_CC-486-: Pilot Study of CC 486 (Oral Azacitidine) Plus BSC as Maintenance After sc Azacitidine in Elderly HR-IPSS-R MDS Patients (clinicaltrials.gov)
P2, N=11, Active, not recruiting, University of Florence | Recruiting --> Active, not recruiting | Trial completion date: Jul 2024 --> Dec 2024 | Trial primary completion date: Jul 2023 --> Aug 2024
Enrollment closed • Trial completion date • Trial primary completion date
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Onureg (azacitidine oral)
7ms
Phase II Anti-PD1 Epigenetic Therapy Study in NSCLC. (clinicaltrials.gov)
P2, N=143, Completed, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | N=101 --> 143
Enrollment change • Metastases
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EGFR (Epidermal growth factor receptor) • KRAS (KRAS proto-oncogene GTPase) • ALK (Anaplastic lymphoma kinase)
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EGFR mutation • EGFR exon 19 deletion • ALK positive • ALK rearrangement • EGFR wild-type • ALK wild-type • ALK translocation
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Opdivo (nivolumab) • Jingzhuda (entinostat) • Onureg (azacitidine oral)
7ms
A Post-Marketing Surveillance Study to Assess the Safety of Oral Azacitidine Maintenance Therapy in Korean Patients With Acute Myeloid Leukemia (clinicaltrials.gov)
P=N/A, N=154, Recruiting, Bristol-Myers Squibb | Not yet recruiting --> Recruiting | Trial completion date: Sep 2029 --> May 2029 | Trial primary completion date: Jan 2028 --> Aug 2027
Enrollment open • Trial completion date • Trial primary completion date
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Onureg (azacitidine oral)
7ms
Oral Azacitidine Combined With Venetoclax in Previously Untreated Higher-risk Myelodysplastic Syndromes (clinicaltrials.gov)
P1/2, N=36, Recruiting, Groupe Francophone des Myelodysplasies | Not yet recruiting --> Recruiting
Enrollment open • Combination therapy
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Venclexta (venetoclax) • Onureg (azacitidine oral)
7ms
Testing CC-486 (Oral Azacitidine) Plus the Standard Drug Therapy in Patients 75 Years or Older With Newly Diagnosed Diffuse Large B Cell Lymphoma (clinicaltrials.gov)
P2/3, N=422, Recruiting, National Cancer Institute (NCI) | Trial completion date: Mar 2025 --> Mar 2026 | Trial primary completion date: Mar 2025 --> Mar 2026
Trial completion date • Trial primary completion date
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BCL2 (B-cell CLL/lymphoma 2) • BCL6 (B-cell CLL/lymphoma 6) • CD4 (CD4 Molecule)
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BCL6 rearrangement • BCL2 rearrangement
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Rituxan (rituximab) • doxorubicin hydrochloride • cyclophosphamide • vincristine • Onureg (azacitidine oral) • Mabtas (rituximab biosimilar)
7ms
New P4 trial
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Onureg (azacitidine oral)
8ms
ORAZ-351: Oral Azacitidine Maintenance Post-CPX 351 (clinicaltrials.gov)
P=N/A, N=100, Recruiting, Centre Hospitalier Universitaire de Nice
New trial
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Vyxeos (cytarabine/daunorubicin liposomal formulation) • Onureg (azacitidine oral)
8ms
Duvelisib in Combination With BMS-986345 in Lymphoid Malignancy (clinicaltrials.gov)
P1, N=14, Active, not recruiting, H. Lee Moffitt Cancer Center and Research Institute | Recruiting --> Active, not recruiting | N=30 --> 14 | Trial completion date: Oct 2025 --> Mar 2025 | Trial primary completion date: Oct 2025 --> Mar 2024
Enrollment closed • Enrollment change • Trial completion date • Trial primary completion date • Combination therapy
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ALK (Anaplastic lymphoma kinase) • MYC (V-myc avian myelocytomatosis viral oncogene homolog) • BCL2 (B-cell CLL/lymphoma 2) • CD8 (cluster of differentiation 8) • TNFRSF8 (TNF Receptor Superfamily Member 8) • BCL6 (B-cell CLL/lymphoma 6)
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BCL6 rearrangement • BCL2 rearrangement
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Copiktra (duvelisib) • Onureg (azacitidine oral)
8ms
Study of Magrolimab Combinations in Participants With Myeloid Malignancies (clinicaltrials.gov)
P2, N=54, Completed, Gilead Sciences | Active, not recruiting --> Completed
Trial completion
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Venclexta (venetoclax) • cytarabine • etoposide IV • mitoxantrone • magrolimab (ONO-7913) • Onureg (azacitidine oral)
8ms
Enrollment open • Phase classification
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Inqovi (decitabine/cedazuridine) • Onureg (azacitidine oral)
8ms
Oracle: Efficacy and Safety of Oral Azacitidine Compared to Investigator's Choice Therapy in Patients With Relapsed or Refractory AITL (clinicaltrials.gov)
P3, N=86, Active, not recruiting, The Lymphoma Academic Research Organisation | Trial completion date: Feb 2024 --> Jun 2024
Trial completion date
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PD-1 (Programmed cell death 1) • BCL6 (B-cell CLL/lymphoma 6) • CXCL13 (Chemokine (C-X-C motif) ligand 13) • ICOS (Inducible T Cell Costimulator) • MME (Membrane Metalloendopeptidase)
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PD-1 expression
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gemcitabine • bendamustine • Istodax (romidepsin) • Onureg (azacitidine oral)
8ms
A Study of Lenalidomide and CC-486 With Radiation Therapy in Patients With Plasmacytoma (clinicaltrials.gov)
P2, N=21, Active, not recruiting, Memorial Sloan Kettering Cancer Center | Recruiting --> Active, not recruiting
Enrollment closed • Combination therapy
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lenalidomide • Onureg (azacitidine oral)
9ms
Safety and Efficacy Study of CC-486 in Subjects With Myelodysplastic Syndromes (clinicaltrials.gov)
P2, N=65, Completed, Celgene | Active, not recruiting --> Completed | Trial completion date: Dec 2023 --> Sep 2023
Trial completion • Trial completion date • Combination therapy
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Imfinzi (durvalumab) • decitabine • Onureg (azacitidine oral)
9ms
Romidepsin, CC-486 (5-azacitidine), Dexamethasone, and Lenalidomide (RAdR) for Relapsed/Refractory T-cell Malignancies (clinicaltrials.gov)
P1, N=20, Active, not recruiting, National Cancer Institute (NCI) | Recruiting --> Active, not recruiting | N=30 --> 20
Enrollment closed • Enrollment change
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TNFRSF8 positive
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lenalidomide • Istodax (romidepsin) • Onureg (azacitidine oral)
9ms
IMPACT OF CO-MUTATIONS ON THE TRANSPLANT OUTCOMES IN AML PATIENTS WITH DNMT3A MUTATION (EBMT 2024)
Notably, none of the patients received oral azacitidine as maintenance therapy... The results indicated that NPM1-/FLT3-ITD- and NPM1+/FLT3-ITD- subgroups in DNMT3A mutated AML benefit from allo-HSCT in CR1. Larger cohorts are warranted to validate these findings.
Clinical
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FLT3 (Fms-related tyrosine kinase 3) • NRAS (Neuroblastoma RAS viral oncogene homolog) • IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • IDH2 (Isocitrate Dehydrogenase (NADP(+)) 2) • NPM1 (Nucleophosmin 1) • DNMT3A (DNA methyltransferase 1) • ASXL1 (ASXL Transcriptional Regulator 1)
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FLT3-ITD mutation • IDH2 mutation • NPM1 mutation • DNMT3A mutation • ASXL1 mutation
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TruSight Myeloid Sequencing Panel
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Onureg (azacitidine oral)
9ms
IMPACT OF CO-MUTATIONS ON THE TRANSPLANT OUTCOMES IN AML PATIENTS WITH DNMT3A MUTATION (EBMT 2024)
Notably, none of the patients received oral azacitidine as maintenance therapy... The results indicated that NPM1-/FLT3-ITD- and NPM1+/FLT3-ITD- subgroups in DNMT3A mutated AML benefit from allo-HSCT in CR1. Larger cohorts are warranted to validate these findings.
Clinical
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FLT3 (Fms-related tyrosine kinase 3) • NRAS (Neuroblastoma RAS viral oncogene homolog) • IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • IDH2 (Isocitrate Dehydrogenase (NADP(+)) 2) • NPM1 (Nucleophosmin 1) • DNMT3A (DNA methyltransferase 1) • ASXL1 (ASXL Transcriptional Regulator 1)
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FLT3-ITD mutation • IDH2 mutation • NPM1 mutation • DNMT3A mutation • ASXL1 mutation
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TruSight Myeloid Sequencing Panel
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Onureg (azacitidine oral)
10ms
OMNIVERSE: A Study to Assess Safety and Tolerability of CC-486 (ONUREG®, Oral Azacitidine) in Combination Therapy in Participants With Acute Myeloid Leukemia (AML) (clinicaltrials.gov)
P1, N=6, Completed, Celgene | Active, not recruiting --> Completed | Phase classification: P1b --> P1 | N=66 --> 6 | Trial completion date: Apr 2026 --> Jan 2024 | Trial primary completion date: Aug 2024 --> Jan 2024
Trial completion • Phase classification • Enrollment change • Trial completion date • Trial primary completion date • Combination therapy
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Venclexta (venetoclax) • Onureg (azacitidine oral)
10ms
Enrollment open
|
FLT3 (Fms-related tyrosine kinase 3)
|
FLT3 mutation • FLT3 D835 • FLT3 I836
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Xospata (gilteritinib) • Onureg (azacitidine oral)
10ms
Oral Azacitidine Plus Salvage Chemotherapy in Relapsed/Refractory Diffuse Large B Cell Lymphoma (clinicaltrials.gov)
P1, N=9, Completed, Medical University of South Carolina | Active, not recruiting --> Completed
Trial completion
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carboplatin • Onureg (azacitidine oral)
10ms
Trial completion date
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Onureg (azacitidine oral)