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Dr. Grey AI

Peptide

Caspofungin (Cancidas)

Caspofungin is a cyclic lipopeptide echinocandin - the first in its class FDA-approved (2001). Indicated for invasive candidiasis, candidemia, esophageal candidiasis, and invasive aspergillosis. Phase 2/3 trials: 85% response in esophageal candidiasis vs 67% amphotericin B. Active against fluconazole-resistant Candida (MIC90 0.5-1 ug/ml for 157 resistant isolates). Safe profile with only 2% discontinuation in RCTs. Standard comparator for newer echinocandins.

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
2
Outcomes
10
Graded outcomes
4312

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

2 conditions, plus general outcomes

Candidemia and Invasive Candidiasis

Candidemia and Invasive Candidiasis: outcomes studied for Caspofungin (Cancidas)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Invasive Candidiasis Efficacy

Approved for candidemia and invasive Candida infections including intra-abdominal abscesses, peritonitis, pleural cavity infections. Established efficacy in multiple trials. First-line option.

Improves (the measure goes up)Moderate effect35 studies

Studies that measured invasive candidiasis efficacy

and 25 more in the citations list

Esophageal Candidiasis Response

Phase 2 trial (n=128): 85.1% caspofungin vs 66.7% amphotericin B achieved symptom and endoscopic improvement at 2 weeks. Superior efficacy with better tolerability.

Improves (the measure goes up)Large effect34 studies

Studies that measured esophageal candidiasis response

and 24 more in the citations list

Activity vs Fluconazole-Resistant Candida

In vitro: MIC90 0.5-1 ug/ml against 157 fluconazole-resistant isolates. Retained activity against 3,959 clinical Candida isolates. Critical option for azole-resistant infections.

Improves (the measure goes up)Large effect34 studies

Studies that measured activity vs fluconazole-resistant candida

and 24 more in the citations list

Safety and Tolerability

RCTs (n=263): Only 2% discontinued due to drug-related AEs. No serious clinical or laboratory adverse events. Well tolerated in 623 patients studied. Infusion reactions rare.

Improves (the measure goes up)Large effect30 studies

Studies that measured safety and tolerability

and 20 more in the citations list

Invasive Aspergillosis

Invasive Aspergillosis: outcomes studied for Caspofungin (Cancidas)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Invasive Aspergillosis (Salvage)

FDA-approved for refractory invasive aspergillosis based on Phase 2 trial (<100 patients). Response in patients failing other antifungals. Fungistatic mechanism limits first-line use.

Improves (the measure goes up)Moderate effect35 studies

Studies that measured invasive aspergillosis (salvage)

and 25 more in the citations list

General

General: outcomes studied for Caspofungin (Cancidas)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Antimicrobial Activity

19 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect15 studies

Studies that measured antimicrobial activity

and 5 more in the citations list

Immune Function

5 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect9 studies

Studies that measured immune function

Liver Protection

3 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect7 studies

Studies that measured liver protection

Pulmonary Function

2 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect6 studies

Studies that measured pulmonary function

Kidney Function

2 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect6 studies

Studies that measured kidney function

Key findings

  • Invasive Candidiasis EfficacyCandidemia and Invasive CandidiasisImproves (the measure goes up)
  • Esophageal Candidiasis ResponseCandidemia and Invasive CandidiasisImproves (the measure goes up)
  • Activity vs Fluconazole-Resistant CandidaCandidemia and Invasive CandidiasisImproves (the measure goes up)

Safety notes in the studies

  • No serious clinical or laboratory adverse events.

Studies cited

42 studies from PubMed

  1. Efficacy and safety of voriconazole and caspofungin for the treatment of invasive pulmonary aspergillosis in critically ill patients in China.Frontiers in cellular and infection microbiology, 2025 · PMID 40470260
  2. Rezafungin vs caspofungin for the treatment of invasive candidiasis: A systematic review and meta-analysis.Diagnostic microbiology and infectious disease, 2025 · PMID 40651396
  3. Efficacy of initial caspofungin plus trimethoprim/sulfamethoxazole for severe PCP in patients without human immunodeficiency virus infection.BMC infectious diseases, 2023 · PMID 37328748
  4. Efficacy and safety of caspofungin for patients with hepatic insufficiency.BMC infectious diseases, 2022 · PMID 35725403
  5. Pharmacokinetics/Pharmacodynamics of Caspofungin in Plasma and Peritoneal Fluid of Liver Transplant Recipients.Antimicrobial agents and chemotherapy, 2022 · PMID 34662185
  6. Caspofungin Effects on Electrocardiogram of Mice: An Evaluation of Cardiac Safety.Cardiovascular toxicology, 2021 · PMID 32845461
  7. Caspofungin combined with TMP/SMZ as a first-line therapy for moderate-to-severe PCP in patients with human immunodeficiency virus infection.HIV medicine, 2021 · PMID 33277811
  8. Factors influencing caspofungin plasma concentrations in kidney transplant patients with high incidence of invasive fungal infections.Journal of clinical pharmacy and therapeutics, 2020 · PMID 31468555
  9. Caspofungin: a review of its characteristics, activity, and use in intensive care units.Expert review of anti-infective therapy, 2020 · PMID 32662712
  10. Caspofungin for primary antifungal prophylaxis after T-cell-replete haploidentical stem cell transplantation with post-transplant cyclophosphamide.European journal of haematology, 2019 · PMID 30672611
  11. Adsorption and caspofungin dosing during continuous renal replacement therapy.Critical care (London, England), 2019 · PMID 31266525
  12. Effect of Caspofungin vs Fluconazole Prophylaxis on Invasive Fungal Disease Among Children and Young Adults With Acute Myeloid Leukemia: A Randomized Clinical Trial.JAMA, 2019 · PMID 31688884
  13. Caspofungin dosage adjustments are not required for patients with Child-Pugh B or C cirrhosis.The Journal of antimicrobial chemotherapy, 2018 · PMID 29860319
  14. Successful treatment with caspofungin of candiduria in a child with Wilms tumor; review of literature.Journal de mycologie medicale, 2017 · PMID 28188050
  15. Efficacy and safety of caspofungin in children: systematic review and meta-analysis.Archivos argentinos de pediatria, 2016 · PMID 27399007
  16. Pharmacokinetics and safety of intravitreal caspofungin.Antimicrobial agents and chemotherapy, 2014 · PMID 25246398
  17. Caspofungin for prophylaxis and treatment of fungal infections in adolescents and adults: a meta-analysis of randomized controlled trials.Die Pharmazie, 2012 · PMID 22570929
  18. Efficacy and safety of caspofungin in obese patients.Medical mycology, 2011 · PMID 21466264
  19. Caspofungin therapy in immunocompromised children and neonates.Expert review of anti-infective therapy, 2011 · PMID 21417874
  20. Synthesis of the antifungal beta-1,3-glucan synthase inhibitor CANCIDAS (caspofungin acetate) from pneumocandin B0.The Journal of organic chemistry, 2007 · PMID 17343416
  21. Caspofungin for the treatment of fungal infections: a systematic review of randomized controlled trials.International journal of antimicrobial agents, 2007 · PMID 17207609
  22. Echinocandin antifungals: review and update.Expert review of anti-infective therapy, 2006 · PMID 16597212
  23. Pharmacological properties and clinical efficacy of a recently licensed systemic antifungal, caspofungin.Mycoses, 2005 · PMID 15982202
  24. Caspofungin as first line therapy of pulmonary invasive fungal infections in 32 immunocompromised patients with hematologic malignancies.European journal of haematology, 2005 · PMID 16104879
  25. Caspofungin: a review of its use in the treatment of fungal infections.Drugs, 2005 · PMID 16162025
  26. Caspofungin: the first agent available in the echinocandin class of antifungalsJ Antimicrob Chemother, 2004 · PMID 15145631
  27. Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropeniaN Engl J Med, 2004 · PMID 14645748
  28. Caspofungin: first approved agent in a new class of antifungalsClin Infect Dis, 2003 · PMID 12740003
  29. In vitro activities of caspofungin compared with those of fluconazole and itraconazole against 3,959 clinical isolates of Candida spp., including 157 fluconazole-resistant isolatesAntimicrob Agents Chemother, 2003 · PMID 12604543
  30. Caspofungin: the first representative of a new antifungal class.The Journal of antimicrobial chemotherapy, 2003 · PMID 12615851
  31. Caspofungin: the first in a new class of antifungal agents.Drug resistance updates : reviews and commentaries in antimicrobial and anticancer chemotherapy, 2003 · PMID 12962685
  32. Echinocandin antifungal drugs.Lancet (London, England), 2003 · PMID 14550704
  33. [New antifungal agents: voriconazole and caspofungin].Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 2003 · PMID 15022787
  34. Caspofungin: a review of its use in oesophageal candidiasis, invasive candidiasis and invasive aspergillosis.Drugs, 2003 · PMID 14498760
  35. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosisN Engl J Med, 2002 · PMID 12384840
  36. Caspofungin: an echinocandin antifungal agentClin Ther, 2002 · PMID 12148449
  37. Caspofungin: an echinocandin antifungal agent.Clinical therapeutics, 2002 · PMID 11952021
  38. The role of caspofungin and the echinocandins in the antifungal armamentarium.Current opinion in investigational drugs (London, England : 2000), 2002 · PMID 12431014
  39. Safety and tolerability of caspofungin acetate in the treatment of fungal infectionsDrugs, 2001 · PMID 12123423
  40. Caspofungin for the treatment of esophageal candidiasisClin Infect Dis, 2001 · PMID 11353808
  41. Caspofungin acetate: an antifungal agent.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2001 · PMID 11449878
  42. Caspofungin: pharmacology, safety and therapeutic potential in superficial and invasive fungal infections.Expert opinion on investigational drugs, 2001 · PMID 11772269