Dr. Grey AI

Caspofungin (Cancidas)

Peptide

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.

Quick Answer

What it is

Caspofungin is a cyclic lipopeptide echinocandin - the first in its class FDA-approved (2001). Indicated for invasive candidiasis, candidemia, esophageal candidiasis, and invasive aspergillosis.

Key findings

  • Grade A: Esophageal Candidiasis Response (Candidemia and Invasive Candidiasis)
  • Grade A: Invasive Candidiasis Efficacy (Candidemia and Invasive Candidiasis)
  • Grade A: Activity vs Fluconazole-Resistant Candida (Candidemia and Invasive Candidiasis)

Safety

  • No serious clinical or laboratory adverse events.
⚠️ Research Notice

This peptide information is for educational and research purposes only. Peptides may not be FDA-approved for human use and may only be legally available for research purposes. Consult qualified healthcare professionals before considering any peptide compounds.

ℹ️ Quick Facts: Caspofungin (Cancidas)

Quick Facts: Caspofungin (Cancidas)

  • Best Evidence:Grade A
  • Conditions Studied:2
  • Research Outcomes:10
  • Grade A Findings:4
  • Grade B Findings:3
  • Key Effect:Candidemia and Invasive Candidiasis
A4
B3
C1
D2
2 conditions Β· 10 outcomes

Detailed Outcomes

|
A
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.
large↑Improves
A
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.
moderate↑Improves
A
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.
large↑Improves
A
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.
large↑Improves
B
Antimicrobial Activity
19 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.
moderate↑Improves
B
Immune Function
5 human trials support this finding. Human clinical trial data available.
small↑Improves
C
Liver Protection
3 human trials support this finding. Human clinical trial data available.
small↑Improves
D
Pulmonary Function
2 human trials support this finding. Human clinical trial data available.
small↑Improves
D
Kidney Function
2 human trials support this finding. Human clinical trial data available.
small↑Improves
B
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.
moderate↑Improves

Research Citations (42)

Efficacy and safety of voriconazole and caspofungin for the treatment of invasive pulmonary aspergillosis in critically ill patients in China.
(2025)
PMID: 40470260
Rezafungin vs caspofungin for the treatment of invasive candidiasis: A systematic review and meta-analysis.
(2025)
PMID: 40651396
Efficacy of initial caspofungin plus trimethoprim/sulfamethoxazole for severe PCP in patients without human immunodeficiency virus infection.
(2023)
PMID: 37328748
Efficacy and safety of caspofungin for patients with hepatic insufficiency.
(2022)
PMID: 35725403
Pharmacokinetics/Pharmacodynamics of Caspofungin in Plasma and Peritoneal Fluid of Liver Transplant Recipients.
(2022)
PMID: 34662185
Caspofungin Effects on Electrocardiogram of Mice: An Evaluation of Cardiac Safety.
(2021)
PMID: 32845461
Caspofungin combined with TMP/SMZ as a first-line therapy for moderate-to-severe PCP in patients with human immunodeficiency virus infection.
(2021)
PMID: 33277811
Factors influencing caspofungin plasma concentrations in kidney transplant patients with high incidence of invasive fungal infections.
(2020)
PMID: 31468555
Caspofungin: a review of its characteristics, activity, and use in intensive care units.
(2020)
PMID: 32662712
Caspofungin for primary antifungal prophylaxis after T-cell-replete haploidentical stem cell transplantation with post-transplant cyclophosphamide.
(2019)
PMID: 30672611

Related Peptides

Rezafungin (Rezzayo)

Peptide

1 shared condition Β· 6 outcomes

Rezafungin is a second-generation cyclic lipopeptide echinocandin antifungal. FDA-approved March 2023 for candidemia and invasive candidiasis - first new echinocandin in over a decade. ReSTORE Phase 3 trial (n=199): Noninferior to caspofungin for day-14 global cure and 30-day mortality. Weekly dosing (vs daily for other echinocandins) enables outpatient treatment. Inhibits (1,3)-beta-D-glucan synthase to disrupt fungal cell wall.

Micafungin (Mycamine)

Peptide

1 shared condition Β· 10 outcomes

Micafungin is a cyclic lipopeptide echinocandin antifungal. FDA-approved 2005 for esophageal candidiasis, invasive candidiasis/candidemia, and uniquely for Candida prophylaxis in HSCT recipients. Clinical trials (n=3028 pooled): Favorable safety profile. Superior to fluconazole for HSCT prophylaxis. Fungicidal against Candida including fluconazole-resistant strains. Second echinocandin approved in US after caspofungin.

Anidulafungin

Peptide

1 shared condition Β· 6 outcomes

Anidulafungin is a cyclic lipopeptide echinocandin antifungal for invasive candidiasis and candidemia. FDA-approved 2006. A-GRADE evidence: Phase 3 trial showed 76% success vs 60% fluconazole (P=0.01). Potent activity against Candida albicans, C. glabrata, C. tropicalis, C. krusei (MIC90 0.06-0.12 ΞΌg/ml). Crucially, 99% of fluconazole-resistant isolates remain susceptible. No hepatic or renal dose adjustment needed due to non-CYP450 metabolism - advantageous in critically ill patients. PRESCRIPTION ONLY - IV administration.