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Irinotecan liposome (Onivyde) is a nanoliposomal formulation of the topoisomerase I inhibitor irinotecan. Developed to improve the pharmacokinetic profile and tumor-specific delivery of irinotecan and its active metabolite, SN-38, the liposomal encapsulation protects the drug from premature metabolism and allows for prolonged circulation and preferential accumulation in tumor tissues via the enhanced permeability and retention (EPR) effect. It was first approved by the FDA in 2015 for use in combination with 5-fluorouracil and leucovorin for the treatment of patients with metastatic adenocarcinoma of the pancreas whose disease has progressed following gemcitabine-based therapy. More recently, it has been approved as a first-line treatment for metastatic pancreatic adenocarcinoma in combination with oxaliplatin, fluorouracil, and leucovorin (NALIRIFOX). It is also under investigation for other solid tumors, including biliary tract cancer and small cell lung cancer.
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