Perfosfamide

Perfosfamide
Systematic (IUPAC) name
(2S,4S)-N,N-Bis(2-chloroethyl)-4-hydroperoxy-2-oxo-1,3,2λ5-oxazaphosphinan-2-amine
Clinical data
Trade names Pergamid
Legal status
  • (Prescription only)
Dependence
liability
none
Routes of
administration
extracorporal treatment of cellular masses; intravenously
Identifiers
CAS Number 39800-16-3 YesY
ATC code L01
PubChem CID 38347
ChemSpider 35147 YesY
ChEBI CHEBI:196991 YesY
ChEMBL CHEMBL61511 YesY
Synonyms Perfosfamide
Chemical data
Formula C7H15Cl2N2O4P
Molar mass 293.084762 g/mol
 NYesY (what is this?)  (verify)

Perfosfamide, or 4-hydroperoxycyclophosphamide (trade name Pergamid) was an experimental drug candidate for blood cancers that was rejected by the FDA in 1993 and never reached the market.

Intended use

Perfosfamide was used experimentally by oncologists in the 1980s for use in bone marrow transplant procedures for treatment of blood cancers. It was added to the tissue after it had been taken from the donor but before the tissue was administered to the patient to "purge" lymphocytes in order to prevent Graft Versus Host Disease, which results from donor lymphocytes attacking normal host cells and tissues, and to "purge" a patient's own (autologous) collected hematopoietic stem cells of any malignant cells it may still contain at the time of harvesting.[1][2]:255

In 1989 Nova Pharmaceutical took over development of the compound and in 1992, it submitted a new drug application to the FDA for using perfosamide to purge malignant cells in transplants for the treatment of acute myeloid leukemia. In the ensuing year, it merged with Scios to become Scios Nova. In March 1993, the FDA's Oncology Drugs Advisory Committee rejected the application because all the data was from the experimental uses, and no randomized clinical trial had been conducted.[3] At the review meeting, Scios Nova also announced that it would not fund further development of the drug candidate.[4]

Chemistry

Perfosfamide is an oxazaphosphorine compound, similar to mafosfamide and cyclophosphamide. Like those compounds it, is metabolized to 4-hydroxycyclophosphamide, which eventually gives rise to the two directly cytotoxic metabolites - phosphoramide mustard and acrolein.[5]

References

  1. Sládek NE. Aldehyde dehydrogenase-mediated cellular relative insensitivity to the oxazaphosphorines. Curr Pharm Des. 1999 Aug;5(8):607-25. Review. PMID 10469894
  2. O Michael Colvin. Pharmacologic Purging of Bone Marrow. Chapter 20 in Thomas' Hematopoietic Cell Transplantation, Volume 457. Eds. Thomas E.D. et al. John Wiley & Sons, 2004 ISBN 9781405112567
  3. Jeffrey L. Fox. Scios Nova may purge Pergamid after FDA setback. Nature Biotechology. April 1993 11(4):439 doi 10.1038/nbt0493-439
  4. The Pink Sheet. 8 March 1993 Scios Nova’s Pergamid: No Further Trials Will Be Funded
  5. Ludeman SM. The chemistry of the metabolites of cyclophosphamide. Curr Pharm Des. 1999 Aug;5(8):627-43. PMID 10469895
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