This study is designed to examine blood levels of ASTX727, a fixed-dose combination tablet containing the combination of cedazuridine (100 mg) and decitabine (35 mg), when given under fed versus fasted conditions to participants with myelodysplastic syndromes (MDS), including refractory anemia with excess blasts in transformation or chronic myelomonocytic leukemia (CMML), or acute myeloid leukemia (AML). This study will also assess the safety of ASTX727.
This is a Phase 1b, multicenter, open-label, randomized, two-sequence, crossover study of ASTX727 in participants with MDS, including refractory anemia with excess blasts in transformation or CMML, and AML. Participants will continue to be enrolled until evaluable data is collected from 12 participants. It is expected that approximately 18 participants will be enrolled in total. This study will be conducted in 28-day cycles. All participants will take part in Cycle 1 and may continue into Cycles ≥2 at the investigator's discretion. Participants will receive one tablet of ASTX727 containing 100 mg cedazuridine and 35 mg decitabine once daily for 5 days in 28-day cycles starting from Cycle 1 Day 1. Participants will be randomized in a 1:1 ratio to receive high-calorie, high-fat breakfast meal pre-dose on either Day 2 or Day 4 of Cycle 1. Blood will be drawn at specified time points in Cycle 1 on Days 2 through 5 to assess the effect of food on the PK of cedazuridine and decitabine. After completion of the first treatment cycle, participants may continue to receive treatment with ASTX727 at the investigator's discretion for subsequent cycles (Days 1 through 5 of 28-day cycles), until disease progression, unacceptable toxicity, investigator decision to discontinue treatment, or the participant decides to discontinue treatment or withdraw from the study. In Cycles ≥2, participants will fast for 2 hours before and 2 hours after taking the ASTX727 tablet on all dosing days.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
ASTX727 is an oral drug product composed of a fixed-dose combination of cedazuridine (E7727), a CDA inhibitor, and decitabine. Food is a high-calorie, high-fat breakfast meal of 800-1000 calories given on Day 2.
ASTX727 is an oral drug product composed of a fixed-dose combination of cedazuridine (E7727), a CDA inhibitor, and decitabine. Food is a high-calorie, high-fat breakfast meal of 800-1000 calories given on Day 4.
Roswell Park
Buffalo, New York, United States
Gabrail Cancer Center
Canton, Ohio, United States
Vanderbilt
Nashville, Tennessee, United States
Mays Cancer Center UT Health San Antonio MD Anderson Cancer Center
San Antonio, Texas, United States
AUC0-t (area under the concentration-time curve from time 0 to t hours).
Area under the concentration-time curve from time 0 to t hours.
Time frame: 6 months
AUC0-8 (area under the concentration-time curve from time 0 to 8 hours).
Area under the concentration-time curve from time 0 to 8 hours.
Time frame: 6 months
AUC0-24 (area under the concentration-time curve from time 0 to 24 hours).
Area under the concentration-time curve from time 0 to 24 hours
Time frame: 6 months
AUC0-inf (area under the concentration-time curve from time 0 to infinity).
Area under the concentration-time curve from time 0 to infinity.
Time frame: 6 months
Cmax (maximum plasma concentration).
Maximum plasma concentration.
Time frame: 6 months
hemoglobin level
Assessed in g/dL
Time frame: 6 months
platelet count
Assessed as 10\^9/L
Time frame: 6 months
white blood cell count
Assessed as fraction of 1
Time frame: 6 months
neutrophils
Assessed as percent
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Enrollment
18
Time frame: 6 months
Subject-reported and investigator-observed incidence and severity of adverse events.
Time frame: 6 months