daunorubicin

Overview

Daunorubicin (daunomycin) is an anthracycline that intercalates DNA and inhibits topoisomerase II, inducing double-strand breaks and apoptosis. It is one of the oldest and most widely used cytotoxics in AML induction, typically used in the “7+3” regimen (7 days cytarabine + 3 days daunorubicin) or CPX-351 (liposomal cytarabine/daunorubicin). It is closely related to idarubicin, which is preferred in many modern AML protocols.

Evidence in the corpus

  • Referenced as the anthracycline component of standard “7+3” induction chemotherapy (daunorubicin + cytarabine) in AML and MDS; the WashU decitabine trial (NCT01687400, N=116) contrasted 10-day decitabine against conventional anthracycline+cytarabine induction, which yields only 20–30% CR rates and 4–6-month median survival in TP53-mutant AML PMID:27959731

Resistance mechanisms

  • TP53 mutations are associated with resistance to anthracycline-based AML induction; TP53-mutant patients have CR rates of 20–30% and median OS of 4–6 months on cytarabine + anthracycline induction PMID:27959731

Cancer types (linked)

  • AML — standard 7+3 induction; TP53-mutant AML is largely resistant.
  • MDS — occasional induction use in high-risk transformed MDS.

Sources

  • PMID:27959731 — Welch et al. 2016, NEJM. WashU AML/MDS decitabine trial; daunorubicin + cytarabine 7+3 as comparator; TP53-mutant AML yields only 4–6-month median OS on conventional induction.

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