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Pegargiminase + venetoclax + azacitidine is an investigational triplet combination therapy being developed by Polaris Group in collaboration with MD Anderson Cancer Center. The regimen combines pegargiminase (ADI-PEG 20), a PEGylated arginine-degrading enzyme, with the standard-of-care doublet of venetoclax (a BCL-2 inhibitor) and azacitidine (a hypomethylating agent). Pegargiminase works by depleting extracellular arginine, targeting tumors that are deficient in argininosuccinate synthetase (ASS1), such as acute myeloid leukemia (AML). This metabolic targeting is intended to sensitize AML cells to the pro-apoptotic effects of venetoclax and the epigenetic modifications induced by azacitidine. The combination is currently in Phase 1 clinical trials for newly diagnosed adverse-risk and relapsed/refractory AML.
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