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The combination of azacitidine (or its oral form CC-486) with fulvestrant is an investigational therapy for estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer in postmenopausal women who have progressed on aromatase inhibitor therapy. Azacitidine is a hypomethylating agent that acts as an epigenetic modulator, while fulvestrant is a selective estrogen receptor degrader. The rationale for combining these agents is to leverage the epigenetic modifying effects of azacitidine to potentially restore sensitivity to endocrine therapy and improve outcomes[1][4].
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