What is Vyxeos? How is it administered?

What is Vyxeos?

Vyxeos is kind of an interesting drug. It's a combination of two drugs, actually, that are commonly used for induction therapy in AML. And those two drugs are Daunorubicin and Cytarabine. Vyxeos is a liposomal encapsulated formulation of those two drugs in a fixed molar concentration ratio that is shown to be synergistic. So what you get with Vyxeos is the two drugs Daunorubicin and Cytarabine delivered together within a liposome directly to the cancer cell at the appropriate synergistic ratio that makes them work ideally together and gives them a better chance of killing the cells together than each individual drug by itself.

How is Vyxeos different than 7+3?

Vyxeos is a liposomal encapsulated formulation of 7+3, so it encapsulates both Daunorubicin and Cytarabine in a fixed concentration ratio that allows for the drugs to be delivered together to the cancer cell to optimize cell killing. So they're the same drugs but given in a different formulation that's more advantageous when it comes to drug delivery.

How is Vyxeos administered?

Vyxeos is administered as an IV infusion given typically as a single daily dose on days one, three, and five, so a total of three doses for each round or each induction regimen. In consolidation, it's typically given as a two-dose schedule. So Vyxeos is typically administered as an intravenous infusion on day one, day three, and day five. So three doses, each dose about 48 hours apart. It can be given as an inpatient or in the outpatient setting as well. Many centers are now transitioning more to outpatient-based induction with regimens that are easy to administer, like Vyxeos, that don't take very long, provided that there's enough support to allow patients to be seen quickly or come back in quickly if they get sick. But it can be done either as inpatient-based therapy or outpatient-based therapy. And at our center, we do some of both, depending on the patient's particular situation.

The dosing of Vyxeos is typically 100 units per meter squared on days one, three, and five as induction therapy. The dose is not usually modified during induction, but it is modified downward during subsequent post-remission cycles. Consolidation therapy, in other words, where we don't want to cause as much or as severe or prolonged periods of side effects. So the dose is typically reduced during consolidation and given on days one and three only instead of days one, three, and five.