ClinicalTrials.gg
RecruitingNCT04608110Updated Aug 10, 2026

A Phase 1 Trial of ASTX030 in Patients With Myelodysplastic Syndrome

A Phase 1 interventional study of ASTX030 (AZA + CED) and ASTX030 (AZA + CED) in Myelodysplastic Syndrome (MDS), sponsored by Taiho Pharmaceutical Co., Ltd.. Recruiting at 10 sites in Japan. Open to participants aged 20 Years and older. Per ClinicalTrials.gov, last updated 2026-08-10.

Sponsored by Taiho Pharmaceutical Co., Ltd. (part of Otsuka Holdings Co., Ltd.) · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Started Oct 2020; still recruiting 6 years later.
Phase
Phase 1
Study type
Interventional
Enrollment
59
Allocation
Randomized
Ages
20 Years and older
Sex
All
01

Study summary

[Tolerability Assessment Part] The purpose is to identify the doses of the oral azacitidine(AZA) formulations and cedazuridine (CED) tablets which achieve a total AUC for AZA comparable to that for AZA injection at 75 mg/m2.

[Expansion Assessment Part] The purpose is to compare the total AUC for AZA after administration of ASTX030 with that after administration of AZA injection at 75 mg/m2.

02

Conditions studied

  • Myelodysplastic Syndrome (MDS)
03

In context

Myelodysplastic Syndromes

1,997 studies on the registry are indexed under Myelodysplastic Syndromes; 324 are open to participants now.

This study's planned enrollment of 59 is above the median of 40 across 1,611 interventional studies indexed under Myelodysplastic Syndromes.

Browse Myelodysplastic Syndromes studies →

Lead sponsor

Taiho Pharmaceutical Co., Ltd. is the lead sponsor of 43 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
20 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

[Tolerability Assessment Part】

  • Patients aged 20 years or older
  • Patients with a diagnosis of MDS ( anemia [RA], refractory anemia with ringed sideroblasts [RARS], refractory anemia with excess blasts [RAEB], refractory anemia with excess blasts in transformation [RAEB-T], or chronic myelomonocytic leukemia [CMML]) according to the French-American-British (FAB) classification. Low-risk patients who fall under the risk category of low or intermediate-1 (Int-1) based on the International Prognostic Scoring System (IPSS) can be enrolled only if they are unlikely to respond to any other treatment or if they are currently being treated with AZA injection.
  • Patients with an PS score of 0 or 1
  • Patients with adequate organ function as indicated below

    1. Hepatic function: All of the following criteria must be satisfied

  • Total ≤ 2.0 × (ULN)
  • (AST) ≤ 2.5 × ULN
  • Alanine aminotransferase (ALT) ≤ 2.5 × ULN 2. Renal function: The following criteria must be satisfied
  • or ≥ 50 mL/min 3. Respiratory function: percutaneous arterial oxygen saturation (SpO₂) ≥ 90%
  • Patients who are expected to survive for at least 3 months
  • Patients who give written consent to participate in the trial using the form approved by the institutional review board

[Expansion Assessment Part]

  • Patients aged 20 years or older
  • Patients with a diagnosis of MDS (RA, RARS, RAEB, RAEB-T, or CMML) according to the FAB classification, who are categorized as Int-2 or high risk according to the IPSS
  • Patients with an ECOG PS score of 0 or 1
  • Patients with adequate organ function as indicated below

    1. Hepatic function: All of the following criteria must be satisfied

  • Total bilirubin ≤ 2.0 ×ULN
  • AST ≤ 2.5 × ULN
  • ALT ≤ 2.5 × ULN 2. Renal function: The following criteria must be satisfied
  • Creatinine clearance or glomerular filtration rate ≥ 50 mL/min 3. Respiratory function: percutaneous arterial oxygen saturation (SpO₂) ≥ 90%
  • Patients who are expected to survive for at least 3 months
  • Patients who give written consent to participate in the trial using the informed consent form approved by the institutional review board

Exclusion criteria

Exclusion Criteria:

[Tolerability Assessment Part]

  • Patients who are unlikely to respond to AZA
  • Patients who have received chemotherapy, hormone therapy, antibody therapy, radiotherapy, or other exploratory anti-cancer treatments for the primary disease within 3 weeks prior to the first administration of the medicinal product (IMP)
  • Patients who have used any other IMP or any privately imported medicine within 4 weeks prior to the first administration of IMP
  • Patients with heart disease of Class 3 or 4 according to the classification
  • Patients with uncontrolled systemic disease or active infection
  • Patients with uncontrolled gastric or duodenal ulcer
  • Patients with prior or current interstitial lung disease
  • Patients with a history of surgical gastrectomy
  • Patients with life-threatening conditions/symptoms, multiple organ failure, or other factors (including laboratory abnormalities) that, in the opinion of the investigator, are likely to affect their safety or the absorption and metabolism of AZA and CED, or influence the trial evaluation
  • Patients with other (except appropriately treated basal cell carcinoma, squamous cell carcinoma, or cervical carcinoma in situ; prostate or breast cancer stabilized by endocrine therapies; and malignancies that have not for at least 1 year since the last successful treatment)
  • Patients who are positive for antibody, , or antibody
  • Patients with any ≥ Grade 2 AE (except alopecia) associated with prior treatment of the primary disease. However, the parameters defined in inclusion criterion 4) above are excluded.
  • Patients who have undergone a highly invasive and extensive surgical procedure within 4 weeks prior to the first administration of IMP
  • Patients who previously underwent hematopoietic stem cell transplantation and have evidence of (GVHD), or who received immunotherapy within 3 weeks before the start of study treatment.
  • Patients with a history of to the active ingredient or any of IMP
  • Patients who are, in the opinion of the investigator, at high risk for being unable to comply with the trial protocol because of mental disorders or other medical conditions (alcohol/substance abuse or addiction)
  • Pregnant or nursing female patients, or female patients with a positive pregnancy test at screening
  • Sexually active males (except those with a history of bilateral orchiectomy) or females of who do not agree to practice 2 different methods of or remain abstinent during the trial and for 3 months (males) and 6 months (females) after the last dose of IMP
  • Patients who, in the opinion of the investigator, are otherwise ineligible to participate in the trial

[ Expansion Assessment Part]

  • Patients who are unlikely to respond to AZA
  • Patients who have received chemotherapy, hormone therapy, antibody therapy, radiotherapy, or other exploratory anti-cancer treatments for the primary disease within 3 weeks prior to the first administration of the IMP
  • Patients who have received prior treatment with DNA methylation inhibitors, such as decitabine or AZA
  • Patients who have used any other IMP or any privately imported medicine within 4 weeks prior to the first administration of IMP
  • Patients with heart disease of Class 3 or 4 according to the New York Heart Association classification
  • Patients with uncontrolled systemic disease or active infection
  • Patients with uncontrolled gastric or duodenal ulcer
  • Patients with prior or current interstitial lung disease
  • Patients with a history of surgical gastrectomy
  • Patients with life-threatening conditions/symptoms, multiple organ failure, or other factors (including laboratory abnormalities) that, in the opinion of the investigator, are likely to affect their safety or the absorption and metabolism of AZA and CED, or influence the trial evaluation
  • Patients with other malignancies (except appropriately treated basal cell carcinoma, squamous cell carcinoma, or cervical carcinoma in situ; prostate or breast cancer stabilized by endocrine therapies; and malignancies that have not relapsed for at least 1 year since the last successful treatment)
  • Patients who are positive for HIV antibody, HBV-DNA, or HCV antibody
  • Patients with any ≥ Grade 2 AE (except alopecia) associated with prior treatment of the primary disease. However, the parameters defined in inclusion criterion 4) above are excluded.
  • Patients who have undergone a highly invasive and extensive surgical procedure within 4 weeks prior to the first administration of IMP
  • Patients who previously underwent hematopoietic stem cell transplantation and have evidence of GVHD, or who received immunotherapy within 3 weeks before the start of study treatment
  • Patients with a history of hypersensitivity to the active ingredient or any excipient of IMP
  • Patients who are, in the opinion of the investigator, at high risk for being unable to comply with the trial protocol because of mental disorders or other medical conditions (alcohol/substance abuse or addiction)
  • Pregnant or nursing female patients, or female patients with a positive pregnancy test at screening
  • Sexually active males (except those with a history of bilateral orchiectomy) or females of childbearing potential who do not agree to practice 2 different methods of birth control or remain abstinent during the trial and for 3 months (males) and 6 months (females) after the last dose of IMP
  • Patients who, in the opinion of the investigator, are otherwise ineligible to participate in the trial
Terms in these criteria, in plain language(19)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

GVHD (graft-versus-host disease)

After a transplant from a donor, the donor’s immune cells attack the recipient’s body, often the skin, gut or liver.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
59 participants (estimated)

Study arms

  • Experimental
    Tolerability Assessment Part

    Drug: ASTX030 (AZA + CED)

  • Experimental
    Expansion Assessment Part Sequence A

    Drug: ASTX030 (AZA + CED)

  • Experimental
    Expansion Assessment Part Sequence B

    Drug: ASTX030 (AZA + CED)

Interventions

  • DrugASTX030 (AZA + CED)

    In Cycle 1 (28 days per cycle), subcutaneous (SC) AZA will be administered on Day 1, followed by oral AZA formulations and CED tablets on Days 2-7. In Cycle 2 and onward, oral AZA formulations and CED tablets will be administered on Day 1-7.

  • DrugASTX030 (AZA + CED)

    In Cycle 1 (28 days per cycle), ASTX030 will be administered on Days 1-7. In Cycle 2, SC AZA will be administered on Days 1-7 according to a crossover design. From Cycle 3 onward, ASTX030 will be administered on Days 1-7.

  • DrugASTX030 (AZA + CED)

    In Cycle 1 (28 days per cycle), SC AZA will be administered on Days 1-7. In Cycle 2, ASTX030 will be administered on Days 1-7 according to a crossover design. From Cycle 3 onward, ASTX030 will be administered on Days 1-7.

06

What researchers measure

Primary outcomes

  1. [Tolerability Assessment Part] AUC ratio of AZA after administration of oral AZA formulations in combination with CED tablets compared with SC administration of AZA injection.

    Time frame: Up to 1 month

  2. [Expansion Assessment Part] AUC ratio of AZA after administration of ASTX030 compared with SC administration of AZA injection

    Time frame: Up to 2month

07

Study locations

10 of 10 sites recruiting
08

References and documents

Individual participant data

Plan to share: Yes — Anonymized Individual participant data (IPD) that underlie the results of this study will be shared with researchers to achieve aims pre-specified in a methodologically sound research proposal.

Supporting information: Study protocol, Statistical analysis plan

Time frame: Data will be available after marketing approval in global markets, or beginning 1-3 years following article Publication. There is no end date to the availability of the data.

Access criteria: Otsuka will share data on an Otsuka-owned remotely accessible data sharing platform with Python and R analytical software. Research requests should be directed to clinicaltransparency@Otsuka-us.com.

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Oct 2020 (actual). Primary completion is estimated for Dec 2027, 86 months after the start.

Of 84 industry-sponsored phase 1 interventional studies under Myelodysplastic Syndromes, half reached primary completion within 44 months of starting (the median), counting those still running; a quarter within 30 and three quarters within 72. This study's planned 86 months is above that.

Counting every sponsor, half of 218 studies reached it within 52 months; a quarter within 31 and three quarters within 86.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 23, 2020
First posted
Oct 29, 2020
StartActual
Oct 30, 2020
Primary completionEst.
Dec 2027
CompletionEst.
Jan 2028
Last update
Aug 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04608110
Responsible party
Sponsor
First posted
Oct 29, 2020
Start date
Oct 30, 2020
Primary completion
Dec 2027 (estimated)
Completion
Jan 2028 (estimated)
Last update
Aug 10, 2026

Study contacts

Drug Information Center
Contact
ke-watanabe@taiho.co.jp
+81-3-3294-4527
Taiho Pharmaceutical Co., Ltd.
study director · Taiho Pharmaceutical Co., Ltd.

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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