OnCo
drugsProductNot mapped hereapproved

Dactinomycin (actinomycin D)

The first antibiotic used as an anticancer drug (1954) and still the core of chemotherapy for Wilms tumour, rhabdomyosarcoma and gestational trophoblastic disease.

Farber's Wilms tumour work (1950s) established it; approved 1964. VA/DD-4A (Wilms), VAC/IVA (rhabdomyosarcoma), Ewing regimens historically, EMA-CO and pulsed single-agent therapy in GTN. Vesicant; hepatopathy (sinusoidal obstruction) in young children; radiation recall.

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Dactinomycin (actinomycin D) · 2D coordinates (no PubChem conformer)
PubChem
Modality
Actinomycin antibiotic (transcription inhibitor)
Mechanism
Intercalates GC-rich DNA and blocks RNA polymerase elongation; potent radiosensitiser.
Brand / code
Cosmegen
Medicare
Part B (clinician-administered)

Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. Generic; paediatric and gestational trophoblastic uses.

Commercial insurance
covered on label

Multi-source generic; covered under the medical benefit without prior authorisation in most plans, as part of standard regimens.

Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.

Not appraisedSearch NICE
Notes
Long-established generic: never subject to a technology appraisal; funded routinely through hospital formularies and NHS England systemic anti-cancer therapy protocols.
NHS England
Routinely funded for the appraised indication (or via managed access)

Sources: NICE search: dactinomycin. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.

Regulatory

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Approvals

RegionYearIndication
US1964Wilms tumour, rhabdomyosarcoma, Ewing sarcoma, gestational trophoblastic neoplasia, metastatic testicular cancer, regional perfusion for sarcoma

Trials

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ClinicalTrials.gov · phase 2/3
refreshed 2026-09-09
61 studies14 recruiting30 Phase 232 Phase 3
Search “Dactinomycin” on ClinicalTrials.gov →
Counts are from a name search and may include unrelated studies; up to 100 studies are summarised.

Recruiting now (live from ClinicalTrials.gov)

Recruiting trials near you · live from ClinicalTrials.gov
Dactinomycin (actinomycin D)
intervention: Dactinomycin
Open on ClinicalTrials.gov →

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Latest papers

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Latest papers · live from Europe PMC
Open in Europe PMC

Query for this drug: (TITLE:"Dactinomycin" OR ABSTRACT:"Dactinomycin" OR TITLE:"actinomycin D" OR ABSTRACT:"actinomycin D" OR TITLE:"Cosmegen" OR ABSTRACT:"Cosmegen") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Dactinomycin (actinomycin D), not a curated reading list.

Connected

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