Inqovi (decitabine and cedazuridine) vs Asparlas (calaspargase pegol-mknl)

Inqovi (decitabine and cedazuridine) vs Asparlas (calaspargase pegol-mknl)

Inqovi (decitabine and cedazuridine) is an oral hypomethylating agent indicated for the treatment of adults with myelodysplastic syndromes (MDS), including certain types of chronic myelomonocytic leukemia (CMML). Asparlas (calaspargase pegol-mknl) is a modified enzyme used as part of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL). The choice between Inqovi and Asparlas would depend on the specific type of blood cancer a patient has, as they are used to treat different conditions and are not directly interchangeable.

Difference between Inqovi and Asparlas

Metric Inqovi (decitabine and cedazuridine) Asparlas (calaspargase pegol-mknl)
Generic name Decitabine and cedazuridine Calaspargase pegol-mknl
Indications Myelodysplastic syndromes (MDS), including previously treated and untreated, de novo and secondary MDS with the following French-American-British subtypes (refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, and chronic myelomonocytic leukemia) and intermediate-1, intermediate-2, and high-risk International Prognostic Scoring System groups Acute lymphoblastic leukemia (ALL) as a component of a multi-agent chemotherapeutic regimen
Mechanism of action Decitabine is a nucleoside metabolic inhibitor that inhibits DNA methyltransferase, leading to hypomethylation of DNA and cellular differentiation or apoptosis. Cedazuridine is a cytidine deaminase inhibitor that increases the exposure of decitabine. Calaspargase pegol-mknl is an asparagine specific enzyme that depletes the levels of asparagine, an amino acid that is necessary for the growth of leukemic cells, thus inhibiting protein synthesis and resulting in apoptotic cell death.
Brand names Inqovi Asparlas
Administrative route Oral Intravenous
Side effects Fatigue, constipation, hemorrhage, myalgia, mucositis, arthralgia, nausea, dyspnea, diarrhea, rash, dizziness, febrile neutropenia, edema, headache, cough, decreased appetite, upper respiratory tract infection, pneumonia, and transaminase increased Allergic reactions, blood clots, pancreatitis, glucose intolerance, and elevated liver enzymes
Contraindications Hypersensitivity to decitabine, cedazuridine, or any component of the formulation Hypersensitivity to calaspargase pegol, pegaspargase, or any excipients in the formulation; serious hypersensitivity reactions to asparaginase
Drug class Hypomethylating agent, DNA methyltransferase inhibitor Asparagine specific enzyme
Manufacturer Astellas Pharma US, Inc. Servier Pharmaceuticals LLC

Efficacy

Inqovi (decitabine and cedazuridine) Efficacy in Leukemia

Inqovi, a combination of decitabine and cedazuridine, is a medication approved for the treatment of adult patients with myelodysplastic syndromes (MDS), including chronic myelomonocytic leukemia (CMML). MDS are a group of diseases that affect the blood and bone marrow, with CMML being a type of leukemia that shares features of both MDS and acute myeloid leukemia (AML). The efficacy of Inqovi was evaluated in clinical trials where it demonstrated the ability to achieve complete remission or complete remission with partial hematologic recovery in a subset of patients. This outcome is significant as it can lead to a reduction in transfusion dependence for these patients, which is a common complication in MDS and CMML.

The effectiveness of Inqovi was shown in two open-label, randomized, multicenter clinical studies. These studies included patients with MDS and CMML who were either previously untreated or had relapsed or refractory disease. The results indicated that a considerable number of patients treated with Inqovi experienced hematologic improvement or remission. Furthermore, Inqovi offers the convenience of oral administration, providing an alternative to the intravenous administration of decitabine, potentially improving the quality of life for patients by reducing the need for frequent hospital visits.

Asparlas (calaspargase pegol-mknl) Efficacy in Leukemia

Asparlas, known generically as calaspargase pegol-mknl, is a modified enzyme indicated as part of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL) in pediatric and young adult patients. ALL is a type of cancer in which the bone marrow makes too many immature lymphocytes, a type of white blood cell. Asparlas works by depleting the amino acid asparagine, which is essential for the growth of leukemia cells. By doing so, it inhibits the proliferation of these malignant cells.

The efficacy of Asparlas was primarily established through a clinical trial that compared its use with that of another asparagine-depleting drug, pegaspargase, in patients with newly diagnosed ALL. The trial demonstrated that Asparlas was able to maintain asparagine depletion for a longer duration between doses when compared to pegaspargase. This prolonged activity is beneficial in the treatment regimen of ALL, as it allows for less frequent dosing without compromising the efficacy of the treatment. Asparlas is therefore an important component in the therapeutic arsenal against ALL, providing sustained asparagine depletion with a dosing schedule that can improve patient adherence and potentially reduce treatment-related complications.

Regulatory Agency Approvals

Inqovi
  • Food and Drug Administration (FDA), USA
  • Health Canada
Asparlas
  • Food and Drug Administration (FDA), USA

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