Dactinomycin (Cosmegen)

General information

Class/mechanism: Antibiotic oncologic, intercalates between guanine and cytosine DNA base pairs, inhibiting DNA and RNA synthesis.
Route: IV
Extravasation: vesicant

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Endometrial cancer
• Ewing sarcoma
• Gestational trophoblastic neoplasia
• Osteosarcoma
• Rhabdomyosarcoma
• Wilms tumor

Patient drug information

• Dactinomycin (Cosmegen) patient drug information (Chemocare)
• Dactinomycin (Cosmegen) patient drug information (UpToDate)

History of changes in FDA indication

• 12/10/1964: Initial FDA approval
• Unclear date: Approved as part of a combination chemotherapy and/or multi-modality treatment regimen for the treatment of Wilms tumor, childhood rhabdomyosarcoma, Ewing sarcoma and metastatic, nonseminomatous testicular cancer.
• Unclear date: Approved as a single agent, or as part of a combination chemotherapy regimen, for the treatment of gestational trophoblastic neoplasia.
• Unclear date: Approved as a component of regional perfusion for the palliative and/or adjunctive treatment of locally recurrent or locoregional solid malignancies.

Also known as

• Generic names: AC-DE, actinomycin D
• Brand names: Cosmegen, Dacmozen, Lyovac