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Mesutoclax + azacitidine is an investigational combination regimen being developed for the treatment of myeloid malignancies, including acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). Mesutoclax (ICP-248) is an orally bioavailable, highly selective small-molecule B-cell lymphoma-2 (BCL-2) inhibitor that restores normal apoptosis in cancer cells. Azacitidine is a nucleoside metabolic inhibitor (hypomethylating agent) that incorporates into DNA and RNA, leading to DNA methyltransferase inhibition, DNA hypomethylation, and direct cytotoxicity. The combination is being evaluated in clinical trials, including a Phase I study (NCT06656494) and a registrational Phase III head-to-head trial comparing it to the standard-of-care venetoclax + azacitidine in treatment-naive elderly or unfit AML patients.
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