{"entity":{"id":"cytarabine-7-3","kind":"drug","name":"Cytarabine + anthracycline ('7+3')","aka":[],"tldr":"The intensive chemotherapy that has induced remission in fit AML patients since 1973: seven days of one drug, three of another. Still the backbone that targeted drugs are added to.","summary":"Cytarabine 100-200 mg/m² continuous infusion for 7 days with daunorubicin 60-90 mg/m² or idarubicin 12 mg/m² for 3 days. Induces CR in 60-80% of younger adults. Modern practice adds midostaurin or quizartinib (FLT3), gemtuzumab (CD33+ favourable/intermediate risk), or uses CPX-351 (secondary AML). High-dose cytarabine consolidation follows. Five decades of incremental optimisation rather than replacement.","status":"standard-of-care","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Cytarabine","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Cytarabine"}],"tags":[],"related":[],"cancers":["aml","all-leukemia"],"sections":[],"technologies":["cytotoxic-chemotherapy"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["ratify","quantum-first","alfa-0701","aaml0531"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"modality":"Cytotoxic regimen","mechanism":"Cytarabine is a pyrimidine analogue that terminates DNA chain elongation; anthracyclines intercalate DNA and poison topoisomerase II.","approvals":[{"region":"US","year":1969,"indication":"Cytarabine approved for acute leukaemia; 7+3 established 1973"}],"mechanismSteps":["Cytarabine is converted to ara-CTP inside blasts","ara-CTP competes with dCTP and is incorporated into DNA, halting replication","Daunorubicin intercalates DNA and traps topoisomerase II","Double-strand breaks trigger apoptosis in rapidly dividing blasts","Marrow empties (aplasia) then recovers with normal haematopoiesis if leukaemia is cleared"],"dosing":{"route":"IV","schedule":"Cytarabine 100-200 mg/m²/day continuous infusion days 1-7; daunorubicin 60-90 mg/m² or idarubicin 12 mg/m² days 1-3","monitoring":"Daily counts, infection prophylaxis, cardiac function (anthracycline cumulative dose)","source":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=cytarabine"},"toxicity":[{"event":"Profound myelosuppression","anyGradePct":100,"note":"Expected; 2-4 weeks aplasia"},{"event":"Febrile neutropenia / infection","anyGradePct":80},{"event":"Induction mortality","note":"~5% in younger fit adults, higher over 60"},{"event":"Anthracycline cardiotoxicity","note":"Cumulative-dose dependent"}],"access":[],"regulatoryEvents":[]},"route":"/drugs/cytarabine-7-3/","neighbours":{"cancer":[{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/"},{"id":"aml","kind":"cancer","name":"Acute myeloid leukaemia","route":"/cancers/aml/"},{"id":"aml-older-unfit","kind":"cancer","name":"Acute myeloid leukaemia in older or unfit patients","route":"/cancers/aml-older-unfit/"},{"id":"cml-advanced-phase","kind":"cancer","name":"Chronic myeloid leukaemia, accelerated and blast phase","route":"/cancers/cml-advanced-phase/"},{"id":"aml-flt3","kind":"cancer","name":"FLT3-mutated acute myeloid leukaemia","route":"/cancers/aml-flt3/"},{"id":"aml-idh","kind":"cancer","name":"IDH1- and IDH2-mutated acute myeloid leukaemia","route":"/cancers/aml-idh/"},{"id":"aml-npm1-kmt2a","kind":"cancer","name":"NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia","route":"/cancers/aml-npm1-kmt2a/"},{"id":"aml-secondary","kind":"cancer","name":"Secondary and therapy-related acute myeloid leukaemia","route":"/cancers/aml-secondary/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}],"trial":[{"id":"alfa-0701","kind":"trial","name":"ALFA-0701","route":"/trials/alfa-0701/"},{"id":"aaml0531","kind":"trial","name":"COG AAML0531","route":"/trials/aaml0531/"},{"id":"cpx-351-301","kind":"trial","name":"CPX-351 Study 301","route":"/trials/cpx-351-301/"},{"id":"inter-b-nhl-ritux-2010","kind":"trial","name":"Inter-B-NHL Ritux 2010","route":"/trials/inter-b-nhl-ritux-2010/"},{"id":"quantum-first","kind":"trial","name":"QuANTUM-First","route":"/trials/quantum-first/"},{"id":"ratify","kind":"trial","name":"RATIFY (CALGB 10603)","route":"/trials/ratify/"}],"pairing":[{"id":"blinatumomab-frontline-consolidation","kind":"pairing","name":"Blinatumomab added to frontline chemotherapy","route":"/pairings/blinatumomab-frontline-consolidation/"},{"id":"flt3i-plus-7-3","kind":"pairing","name":"FLT3 inhibitor + intensive chemotherapy","route":"/pairings/flt3i-plus-7-3/"}],"paper":[{"id":"paper-quantum-first-quizartinib-lancet-2023","kind":"paper","name":"QuANTUM-First: quizartinib added to intensive chemotherapy and continued as maintenance in newly diagnosed FLT3-ITD AML","route":"/key-papers/paper-quantum-first-quizartinib-lancet-2023/"}],"drug":[{"id":"cytarabine","kind":"drug","name":"Cytarabine","route":"/drugs/cytarabine/"},{"id":"daunorubicin","kind":"drug","name":"Daunorubicin","route":"/drugs/daunorubicin/"}]}}