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CPX-351 (Vyxeos) is a liposomal formulation of the cytotoxic agents daunorubicin and cytarabine, encapsulated at a fixed 1:5 molar ratio. This specific ratio was identified in preclinical studies to maximize synergistic antileukemic activity. The liposomal delivery system optimizes the pharmacokinetics of the two drugs, prolonging their half-life and enhancing their accumulation and persistence within the bone marrow. Cytarabine is a pyrimidine analog that inhibits DNA synthesis by competing with dCTP for incorporation into DNA and inhibiting DNA polymerase. Daunorubicin is an anthracycline that intercalates into DNA and inhibits topoisomerase II, leading to DNA strand breaks and apoptosis. Developed by Celator Pharmaceuticals (acquired by Jazz Pharmaceuticals), CPX-351 is primarily indicated for the treatment of adults and pediatric patients with newly-diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC).
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