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The two old chemotherapy drugs packed together into tiny fat bubbles at a fixed ratio, which doubled five-year survival in older adults with high-risk AML.
Fixed 5:1 molar ratio of cytarabine to daunorubicin in liposomes that persist in marrow. Study 301 (n=309, age 60-75, therapy-related or MDS-related AML): median OS 9.56 vs 5.95 months (HR 0.69), 5-year OS 18% vs 8%; benefit concentrated in patients bridged to transplant. Approved 2017 (adults) and 2021 (paediatric). Being tested in younger high-risk patients and MDS.
Liposomal co-delivery maintains the synergistic drug ratio in leukaemic blasts and prolongs exposure.
1.Liposomes circulate for days and accumulate in bone marrow
Source: US prescribing information (DailyMed). Doses are for orientation; the current label governs.
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. Almost always given inpatient during AML induction, so paid within the Part A stay.
Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
Sources: NICE TA552 · SMC advice: CPX-351 (liposomal daunorubicin-cytarabine). Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
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Adults
Paediatric expansion
| Region | Year | Indication |
|---|---|---|
| US | 2017 | Newly diagnosed therapy-related AML or AML with myelodysplasia-related changes, adults |
| US | 2021 | Paediatric patients ≥1 year |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Prolonged cytopenias Longer neutrophil and platelet recovery than 7+3 | - | - |
| Haemorrhage Study 301, any grade | 74% | - |
| Febrile neutropenia | 68% | - |
| Cardiotoxicity Cumulative anthracycline exposure counts | - | - |
Rates read from the US prescribing information. Blank cells mean the figure was not sourced, not that it is zero.
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Query for this drug: (TITLE:"CPX-351" OR ABSTRACT:"CPX-351" OR TITLE:"liposomal daunorubicin-cytarabine" OR ABSTRACT:"liposomal daunorubicin-cytarabine" OR TITLE:"Vyxeos" OR ABSTRACT:"Vyxeos") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about CPX-351 (liposomal daunorubicin-cytarabine), not a curated reading list.
Shares CPX-351 Study 301, Daunorubicin, Secondary and therapy-related acute myeloid leukaemia, Acute myeloid leukaemia in older or unfit patients.
Shares Daunorubicin, Secondary and therapy-related acute myeloid leukaemia, Cytarabine.
Shares Daunorubicin, Acute myeloid leukaemia in children, Cytarabine, Acute myeloid leukaemia.
Shares Daunorubicin, Acute myeloid leukaemia in children, Cytarabine, Acute myeloid leukaemia.
Shares Daunorubicin, Cytarabine, Acute myeloid leukaemia, Cytotoxic chemotherapy.
Shares Daunorubicin, Cytarabine, Acute myeloid leukaemia.
Shares A Study Evaluating Intensive Chemotherapy With or Without Glasdegib or Azacitidine With or Without Glasdegib In Patients With Previously Untreated Acute Myeloid Leukemia, Acute myeloid leukaemia in older or unfit patients, Acute myeloid leukaemia.
Shares Daunorubicin, Cytarabine, Acute myeloid leukaemia, Cytotoxic chemotherapy.