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Trade names | Aphexda |
Other names | BL-8040 |
AHFS/Drugs.com | Monograph |
License data | |
Routes of administration | Subcutaneous |
Drug class | Antineoplastic |
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Chemical and physical data | |
Formula | C97H144FN33O19S2 |
Molar mass | 2159.55 g·mol−1 |
Motixafortide, sold under the brand name Aphexda, is a medication used for the treatment of multiple myeloma. [1] Motixafortide is a hematopoietic stem cell mobilizer and a CXCR4 antagonist. [1] It is given by subcutaneous injection. [1]
The most common side effects include injection site reactions, pruritus, flushing, and back pain. [3]
Motixafortide was approved for medical use in the United States in September 2023. [3] [4] [5]
Motixafortide is indicated, in combination with filgrastim, a granulocyte-colony stimulating factor (G-CSF), to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in people with multiple myeloma. [1] [3] [4]
Motixafortide can cause injection site reactions, anaphylactic shock, and hypersensitivity reactions. [3] Tumor cell mobilization in people with leukemia, leukocytosis, potential for tumor cell mobilization, and embryo-fetal toxicity can also be caused by motixafortide. [3]
The US Food and Drug Administration (FDA) approved motixafortide based on evidence from the GENESIS study, a double-blind, placebo-controlled study, in which 122 participants with multiple myeloma, due to undergo autologous transplantation, were randomized 2:1 to receive motixafortide 1.25 mg/kg with granulocyte-colony stimulating factor (N=80) or placebo with granulocyte-colony stimulating factor (N=42) for mobilization of hematopoietic stem cells for collection and apheresis. [3] This one trial evaluated the benefit and side effects of motixafortide in participants. [3] The trial was conducted at 21 sites in five countries including Italy, Hungary, Germany, Spain, and the United States. [3] There were 78 participants included in the trial from the United States, and 44 participants included from sites outside of the United States. [3] The GENESIS trial was used to assess efficacy and safety. [3]
Motixafortide is the international nonproprietary name. [6]
Multiple myeloma (MM), also known as plasma cell myeloma and simply myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Often, no symptoms are noticed initially. As it progresses, bone pain, anemia, renal insufficiency, and infections may occur. Complications may include hypercalcemia and amyloidosis.
Granulocyte colony-stimulating factor, also known as colony-stimulating factor 3, is a glycoprotein that stimulates the bone marrow to produce granulocytes and stem cells and release them into the bloodstream.
Filgrastim, sold under the brand name Neupogen among others, is a medication used to treat low neutrophil count. Low neutrophil counts may occur with HIV/AIDS, following chemotherapy or radiation poisoning, or be of an unknown cause. It may also be used to increase white blood cells for gathering during leukapheresis. It is given either by injection into a vein or under the skin. Filgrastim is a leukocyte growth factor.
Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood, in order to replicate inside a patient and produce additional normal blood cells. HSCT may be autologous, syngeneic, or allogeneic.
Granulocyte-macrophage colony-stimulating factor (GM-CSF), also known as colony-stimulating factor 2 (CSF2), is a monomeric glycoprotein secreted by macrophages, T cells, mast cells, natural killer cells, endothelial cells and fibroblasts that functions as a cytokine. The pharmaceutical analogs of naturally occurring GM-CSF are called sargramostim and molgramostim.
Melphalan, sold under the brand name Alkeran among others, is a chemotherapy medication used to treat multiple myeloma; malignant lymphoma; lymphoblastic and myeloblastic leukemia; childhood neuroblastoma; ovarian cancer; mammary adenocarcinoma; and uveal melanoma. It is taken by mouth or by injection into a vein.
Colony-stimulating factors (CSFs) are secreted glycoproteins that bind to receptor proteins on the surfaces of committed progenitors in the bone marrow, thereby activating intracellular signaling pathways that can cause the cells to proliferate and differentiate into a specific kind of blood cell.
Sargramostim is a recombinant granulocyte macrophage colony-stimulating factor (GM-CSF) that functions as an immunostimulator.
Chemokine ligand 2 (CXCL2) is a small cytokine belonging to the CXC chemokine family that is also called macrophage inflammatory protein 2-alpha (MIP2-alpha), Growth-regulated protein beta (Gro-beta) and Gro oncogene-2 (Gro-2). CXCL2 is 90% identical in amino acid sequence as a related chemokine, CXCL1. This chemokine is secreted by monocytes and macrophages and is chemotactic for polymorphonuclear leukocytes and hematopoietic stem cells. The gene for CXCL2 is located on human chromosome 4 in a cluster of other CXC chemokines. CXCL2 mobilizes cells by interacting with a cell surface chemokine receptor called CXCR2.
Plerixafor, sold under the brand name Mozobil, is an immunostimulant used to mobilize hematopoietic stem cells in cancer patients into the bloodstream. The stem cells are then extracted from the blood and transplanted back to the patient. The drug was developed by AnorMED, which was subsequently bought by Genzyme.
Molgramostim is a recombinant granulocyte macrophage colony-stimulating factor which functions as an immunostimulator.
Peripheral blood stem cell transplantation (PBSCT), also called "Peripheral stem cell support", is a method of replacing blood-forming stem cells. Stem cells can be destroyed through cancer treatments such as chemotherapy or radiation, as well as any blood-related diseases, such as leukemia, lymphoma, neuroblastoma and multiple myeloma. PBSCT is now a much more common procedure than its bone marrow harvest equivalent due to the ease and less invasive nature of the procedure. Studies suggest that PBSCT has a better outcome in terms of the number of hematopoietic stem cell yield.
Quizartinib, sold under the brand name Vanflyta, is an anti-cancer medication used for the treatment of acute myeloid leukemia.
Daratumumab, sold under the brand name Darzalex among others, is an anti-cancer monoclonal antibody medication. It binds to CD38, which is overexpressed in multiple myeloma cells. Daratumumab was originally developed by Genmab, but it is now being jointly developed by Genmab along with the Johnson & Johnson subsidiary Janssen Biotech, which acquired worldwide commercialization rights to the drug from Genmab.
Betibeglogene autotemcel, sold under the brand name Zynteglo, is a gene therapy for the treatment for beta thalassemia. It was developed by Bluebird Bio and was given breakthrough therapy designation by the US Food and Drug Administration in February 2015.
Daratumumab/hyaluronidase, sold under the brand name Darzalex Faspro, is a fixed-dose combination medication for the treatment of adults with newly diagnosed or relapsed/refractory multiple myeloma. It is a combination of daratumumab and hyaluronidase. It is administered via subcutaneous injection.
Tafasitamab, sold under the brand name Monjuvi, is a medication used in combination with lenalidomide for the treatment of adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).
Belantamab mafodotin, sold under the brand name Blenrep, is a monoclonal antibody for the treatment of relapsed and refractory multiple myeloma.
Efbemalenograstim alfa, sold under the brand name Ryzneuta, is a medication used to decrease the incidence of infection in chemotherapy-induced neutropenia. It is a leukocyte growth factor. It is given by subcutaneous injection.
High-dose chemotherapy (HDC) is referring to chemotherapy medicines which are given at larger dosages than that are usually used in normal chemotherapy regimens. This therapeutic strategy is used to treat some cancers, especially those that are aggressive or have a high chance of coming back. With increased doses of chemotherapy chemicals administered to the body, HDC seeks to optimize the death of cancer cells.