# CPX-351 (liposomal daunorubicin-cytarabine)

Source: https://onco.cc/drugs/cpx-351/  
OnCo record `cpx-351` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Summary

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.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Brand: Vyxeos
- Modality: Liposomal cytotoxic formulation
- Mechanism: Liposomal co-delivery maintains the synergistic drug ratio in leukaemic blasts and prolongs exposure.
- Approvals: US 2017: Newly diagnosed therapy-related AML or AML with myelodysplasia-related changes, adults; US 2021: Paediatric patients ≥1 year
- Dosing: IV over 90 minutes; Induction days 1, 3, 5 (daunorubicin 44 mg/m² + cytarabine 100 mg/m² per dose); second induction days 1, 3; consolidation at reduced dose

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Daunorubicin/cytarabine
- 5-year results (Lancet Haematology 2021): https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(21)00134-4/abstract

## Connected records

- cancers: [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [Acute myeloid leukaemia in children](https://onco.cc/cancers/aml-paediatric/), [Acute myeloid leukaemia in older or unfit patients](https://onco.cc/cancers/aml-older-unfit/), [Secondary and therapy-related acute myeloid leukaemia](https://onco.cc/cancers/aml-secondary/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/)
- companies: [Jazz Pharmaceuticals](https://onco.cc/companies/jazz/)
- trials: [A Study Evaluating Intensive Chemotherapy With or Without Glasdegib or Azacitidine With or Without Glasdegib In Patients With Previously Untreated Acute Myeloid Leukemia](https://onco.cc/trials/nct03416179/), [A Study to Compare Standard Chemotherapy to Therapy With CPX-351 and/or Gilteritinib for Patients With Newly Diagnosed AML With or Without FLT3 Mutations](https://onco.cc/trials/nct04293562/), [CPX-351 Study 301](https://onco.cc/trials/cpx-351-301/), [myeloMATCH](https://onco.cc/trials/myelomatch/)
- terms: [AML with myelodysplasia-related gene mutations (AML-MR)](https://onco.cc/terms/aml-myelodysplasia-related/)
- drugs: [Cytarabine](https://onco.cc/drugs/cytarabine/), [Daunorubicin](https://onco.cc/drugs/daunorubicin/)

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