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CPX-351 (Vyxeos) is a liposomal formulation of cytarabine and daunorubicin encapsulated in a fixed 5:1 molar ratio. This specific ratio has been shown in vitro to maximize synergistic antileukemic activity. The liposomal delivery system prolongs the half-life of the drugs and facilitates their uptake by bone marrow cells, particularly leukemia blasts, while reducing exposure to non-target tissues. Cytarabine acts as a pyrimidine analog that inhibits DNA polymerase, while daunorubicin is an anthracycline that intercalates DNA and inhibits topoisomerase II. It is FDA-approved for the treatment of adults and pediatric patients (1 year and older) with newly-diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC).
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