- Cardiac function should be monitored regularly in patients receiving DaunoXome (daunorubicin citrate liposome injection) because of the potential risk for cardiac toxicity and congestive heart failure. Cardiac monitoring is advised especially in those patients who have received prior anthracyclines or who have pre-existing cardiac disease or who have had prior radiotherapy encompassing the heart.
- Severe myelosuppression may occur.
- DaunoXome should be administered only under the supervision of a physician who is experienced in the use of cancer chemotherapeutic agents.
- Dosage should be reduced in patients with impaired hepatic function. (See DOSAGE AND ADMINISTRATION)
- A triad of back pain, flushing, and chest tightness has been reported in 13.8% of the patients (16/116) treated with DaunoXome in the Phase III clinical trial, and in 2.7% of treatment cycles (27/994). This triad generally occurs during the first five minutes of the infusion, subsides with interruption of the infusion, and generally does not recur if the infusion is then resumed at a slower rate.
DaunoXome (daunorubicin citrate liposome injection) is a sterile, pyrogen-free, preservative-free product in a single use vial for intravenous infusion.
DaunoXome contains an aqueous solution of the citrate salt of daunorubicin encapsulated within lipid vesicles (liposomes) composed of a lipid bilayer of distearoylphosphatidylcholine and cholesterol (2:1 molar ratio), with a mean diameter of about 45 nm. The lipid to drug weight ratio is 18.7:1 (total lipid:daunorubicin base), equivalent to a 10:5:1 molar ratio of distearoylphosphatidylcholine:cholesterol:daunorubicin. Daunorubicin is an anthracycline antibiotic with antineoplastic activity, originally obtained from Streptomyces peucetius. Daunorubicin has a 4-ring anthracycline moiety linked by a glycosidic bond to daunosamine, an amino sugar. Daunorubicin may also be isolated from Streptomyces coeruleorubidus and has the following chemical name: (8 S-cis)-8-acetyl-10-[(3-amino-2,3,6-trideoxy-α-L- lyxo -hexopyranosyl)oxy]-7,8,9,10-tetrahydro-6,8,11-trihydroxy-1-methoxy-5,12-naphthacenedione hydrochloride.
DaunoXome is indicated as a first line cytotoxic therapy for advanced HIV-associated Kaposi's sarcoma. DaunoXome is not recommended in patients with less than advanced HIV-related Kaposi's sarcoma.
Published Studies Related to Daunoxome (Daunorubicin)
Randomized study of induction therapy comparing standard-dose idarubicin with high-dose daunorubicin in adult patients with previously untreated acute myeloid leukemia: the JALSG AML201 Study. [2011.02.24]
We conducted a multi-institutional randomized study to determine whether high-dose daunorubicin would be as effective as standard-dose idarubicin in remission-induction therapy for newly diagnosed adult patients younger than 65 years of age with acute myeloid leukemia... Thus, high-dose daunorubicin and standard-dose idarubicin were equally effective for the treatment of adult acute myeloid leukemia, achieving a high rate of complete remission and good long-term efficacy.
Infectious complications in patients with acute myeloid leukemia treated according to the protocol with daunorubicin and cytarabine with or without addition of cladribine. A multicenter study by the Polish Adult Leukemia Group (PALG). [2010.02]
OBJECTIVES: The addition of cladribine to the standard regimen consisting of daunorubicin and cytarabine has been reported to increase the efficacy of induction therapy in acute myeloid leukemia (AML). The goal of this study was to determine the effect of this modification on the incidence and spectrum of infectious complications... CONCLUSIONS: The addition of cladribine to standard induction chemotherapy has no impact on the incidence and spectrum of infectious complications in newly diagnosed AML patients. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Daunorubicin versus mitoxantrone versus idarubicin as induction and consolidation chemotherapy for adults with acute myeloid leukemia: the EORTC and GIMEMA Groups Study AML-10. [2009.11.10]
PURPOSE: To compare the antitumor efficacy of three different anthracyclines in combination with cytarabine and etoposide in adult patients with newly diagnosed acute myeloid leukemia (AML)... CONCLUSION: In adult patients with AML who do not receive an allogeneic SCT, the use of mitoxantrone or idarubicin instead of daunorubicin enhances the long-term efficacy of chemotherapy.
High-dose daunorubicin in older patients with acute myeloid leukemia. [2009.09.24]
BACKGROUND: A complete remission is essential for prolonging survival in patients with acute myeloid leukemia (AML). Daunorubicin is a cornerstone of the induction regimen, but the optimal dose is unknown. In older patients, it is usual to give daunorubicin at a dose of 45 to 50 mg per square meter of body-surface area... CONCLUSIONS: In patients with AML who are older than 60 years of age, escalation of the dose of daunorubicin to twice the conventional dose, with the entire dose administered in the first induction cycle, effects a more rapid response and a higher response rate than does the conventional dose, without additional toxic effects. (Current Controlled Trials number, ISRCTN77039377; and Netherlands National Trial Register number, NTR212.) 2009 Massachusetts Medical Society
The value of the MDR1 reversal agent PSC-833 in addition to daunorubicin and cytarabine in the treatment of elderly patients with previously untreated acute myeloid leukemia (AML), in relation to MDR1 status at diagnosis. [2005.10.15]
To determine whether MDR1 reversal by the addition of the P-glycoprotein (P-gp) inhibitor PSC-833 to standard induction chemotherapy would improve event-free survival (EFS), 419 untreated patients with acute myeloid leukemia (AML) aged 60 years and older were randomized to receive 2 induction cycles of daunorubicin and cytarabine with or without PSC-833...
Clinical Trials Related to Daunoxome (Daunorubicin)
DaunoXome + Ara-C vs Daunorubicin + Ara-C in Elderly AML [Completed]
Overall results in the treatment of middle aged adults acute myelogenous leukemia (AML) are
substantially improved in the last decade, with complete remission (CR) rates established to
values of 70 to 80per cent and also encouraging long-term outcome, especially in patients who
can tolerate intensified post remissional treatment strategies. On the contrary, there has
been little progress in the treatment of older patients. In these patients the response rate
generally range between 40 and 60per cent, and overall survival at 2 years is often less than
10 per cent.
Usually, a combination of anthracyclines daunomycin DNR or doxorubicin and cytarabyne Ara-C
has been utilized for the remission-induction treatment, with schedules similar to those
utilized in younger cases, for patients eligible to intensive treatments. Variation of the
dose of DNR has not brought any significant benefit. The EORTC HOVON randomized trial AML9
compared two drugs in induction for previously untreated patients. DNR versus Mithoxantrone
(MTZ). MTZ induction therapy produces a slightly better CR rate than DNR-containing regimen
(47per cent vs 38per cent, P equals 0. 069), without any significant effect on remission
duration and survival. The DFS probability between the two treatment arms was not different.
The median DFS estimates were 39 weeks in both groups. The DFS rate at 5 years was 8per cent.
Also the duration of survival was similar (p equals 0. 23) in the two treatment groups. Median
survival estimates were 36 weeks (DNR) and 39 weeks (MTZ). The percentage of patients still
alive at 5 years were 6per cent and 9per cent respectively.
Alvocidib, Cytarabine, and Mitoxantrone Hydrochloride or Cytarabine and Daunorubicin Hydrochloride in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia [Recruiting]
This randomized phase II trial is studying how alvocidib, cytarabine, and mitoxantrone
hydrochloride work compared to cytarabine and daunorubicin hydrochloride in treating
patients with newly diagnosed acute myeloid leukemia. Alvocidib may stop the growth of
cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in
chemotherapy, such as cytarabine, mitoxantrone hydrochloride, and daunorubicin hydrochloride
work in different ways to stop the growth of cancer cells, either by killing the cells or by
stopping them from dividing. It is not yet known whether giving alvocidib, cytarabine, and
mitoxantrone hydrochloride is more effective than giving cytarabine and daunorubicin
hydrochloride in treating patients with acute myeloid leukemia
Study of Plerixafor Combined With Cytarabine and Daunorubicin in Patients With Newly Diagnosed Acute Myeloid Leukemia [Recruiting]
The purpose of this research study is to determine if plerixafor can make cells more
sensitive to killing by Cytarabine and Daunorubicin, an anti-cancer drug regimen referred to
as "7+3" that is commonly used in treating acute myeloid leukemia (AML). In this study,
plerixafor is used with treatments Cytarabine and Daunorubicin and with and without
granulocyte-colony stimulating factor (GCSF). Subjects will be monitored to see how well
they tolerate the use of these drugs together and how well they work to treat the leukemia.
The purpose of the study is to find the highest dose of plerixafor and/or recommended phase
2 dose that can be given safely with Cytarabine and Daunorubicin and with and without
granulocyte-colony stimulating factor (GCSF).
Study of the Safety, Tolerability, Pharmacokinetics and Pharmacodynamic Properties of Oral AT-406 in Combination With Daunorubicin and Cytarabine in Patients With Poor-risk Acute Myelogenous Leukemia (AML) [Recruiting]
The main purpose of this study are to determine the maximum dose of AT-406 that can be
safely given in combination with cytarabine and daunorubicin to humans. Other purposes are
to determine how the drug is broken down in the body, and to see if there are any molecular
interactions that can help determine how AT-406 works. Side effects will also be studied in
an effort to make sure that this drug is safe to take.
Clofarabine and Daunorubicin in Treating Older Patients With Newly Diagnosed Acute Myeloid Leukemia [Recruiting]
RATIONALE: Drugs used in chemotherapy, such as clofarabine and daunorubicin, work in
different ways to stop the growth of cancer cells, either by killing the cells or by
stopping them from dividing. Giving clofarabine together with daunorubicin may kill more
PURPOSE: This phase II trial is studying how well giving clofarabine together with
daunorubicin works in treating older patients with newly diagnosed acute myeloid leukemia.
Page last updated: 2011-12-09