This study is for patients with a condition called myelodysplastic syndrome (MDS) that has a certain mutation in their genes called IDH2. The study compares two treatments. One is the usual treatment with two drugs combined: cedazuridine and decitabine, known as ASTX727. The other treatment adds a third drug called enasidenib to ASTX727. Cedazuridine helps keep decitabine working longer in your body. Decitabine helps your bone marrow make normal blood cells. Enasidenib stops cancer cells from growing.

• Each treatment cycle lasts 28 days, and the study may require several cycles.
• If you don't improve in 6 cycles, you may switch to the other treatment.
• You may need regular checks, like blood tests and bone marrow samples.

You can join if you haven’t received certain treatments before and meet health criteria such as being 18 or older and having specific blood test results. You must not be pregnant or nursing, as the treatments can be harmful to unborn babies.