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Rigosertib + azacitidine is an investigational combination therapy for myeloid malignancies, primarily myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). Rigosertib is a small molecule Ras-mimetic that inhibits Ras-effector pathways by interfering with the RAS-binding domain of RAF kinases and inhibiting both the RAS-RAF-MEK and PI3K pathways. Azacitidine is a hypomethylating agent that incorporates into DNA and RNA, leading to inhibition of DNA methyltransferase and subsequent epigenetic modulation. The combination aims to overcome resistance to hypomethylating agents in high-risk MDS or AML patients. Clinical studies have shown promising response rates in both HMA-naïve and HMA-refractory populations, with manageable toxicity profiles[1][2][4][5].
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