Dactinomycin (actinomycin D)
The first antibiotic used as an anticancer drug (1954) and still the core of chemotherapy for Wilms tumour, rhabdomyosarcoma and gestational trophoblastic disease.
Farber's Wilms tumour work (1950s) established it; approved 1964. VA/DD-4A (Wilms), VAC/IVA (rhabdomyosarcoma), Ewing regimens historically, EMA-CO and pulsed single-agent therapy in GTN. Vesicant; hepatopathy (sinusoidal obstruction) in young children; radiation recall.
- Medicare
- Part B (clinician-administered)
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. Generic; paediatric and gestational trophoblastic uses.
- Commercial insurance
- covered on label
Multi-source generic; covered under the medical benefit without prior authorisation in most plans, as part of standard regimens.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
- Notes
- Long-established generic: never subject to a technology appraisal; funded routinely through hospital formularies and NHS England systemic anti-cancer therapy protocols.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE search: dactinomycin. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 1964 | Wilms tumour, rhabdomyosarcoma, Ewing sarcoma, gestational trophoblastic neoplasia, metastatic testicular cancer, regional perfusion for sarcoma |
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Latest papers
topQuery for this drug: (TITLE:"Dactinomycin" OR ABSTRACT:"Dactinomycin" OR TITLE:"actinomycin D" OR ABSTRACT:"actinomycin D" OR TITLE:"Cosmegen" OR ABSTRACT:"Cosmegen") 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 Dactinomycin (actinomycin D), not a curated reading list.