decitabine + cedazuridine + thioguanine

decitabine + cedazuridine + thioguanine is an oral combination therapy being investigated by Columbia University for the treatment of relapsed or refractory acute myeloid leukemia (AML). The regimen combines Inqovi (a fixed-dose combination of the hypomethylating agent decitabine and the cytidine deaminase inhibitor cedazuridine) with the purine analog antimetabolite thioguanine (Tabloid). Decitabine acts by inhibiting DNA methyltransferase 1 (DNMT1), leading to DNA hypomethylation and the reactivation of tumor suppressor genes. Cedazuridine is included to inhibit the enzyme cytidine deaminase in the gastrointestinal tract and liver, thereby increasing the oral bioavailability of decitabine. Thioguanine is a guanine analog that, upon metabolic activation, incorporates into DNA and RNA, causing strand breaks and inhibiting synthesis, which ultimately triggers apoptosis. This combination strategy is designed to enhance the efficacy of hypomethylating agents and overcome treatment resistance in patients with advanced myeloid malignancies.

Brand names

InqoviTabloid

Other names

6-thioguanine6-TGdecitabine + cedazuridine + thioguanine6-thioguanine + Inqovi