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ThioTEPA

Systematic (IUPAC) name
1,1',1''-phosphorothioyltriaziridine
Identifiers
CAS number	52-24-4
ATC code	L01AC01
PubChem	5453
Chemical data
Formula	C6H12N3PS
Mol. mass	189.219 g/mol
Pharmacokinetic data
Metabolism	Hepatic (CYP2B6, CYP2C11)
Half life	2.4 hours 15-18 hours (metabolites)
Excretion	Renal
Therapeutic considerations
Pregnancy cat.	D(AU) D(US)
Legal status	POM (UK) ℞-only (US)
Routes	IV, intracavitary, intravesical
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N,N'N'-triethylenethiophosphoramide, abbreviated "ThioTEPA," is an organophosphorus compound with the formula SP(NC₂H₄)₃.^[1]

This cancer chemotherapeutic member of the alkylating agent group is an analogue of N,N',N''- triethylenephosphoramide (TEPA). This molecule features tetrahedral phosphorus and is structurally akin to phosphate. It is derived from aziridine and thiophosphoryl chloride.

History and Awards

ThioTEPA was characterized in 1953^[2] and has been in use since the 1960s. Since the beginning of the twenty first century, some features of the product pushed in favor of its use in new indications.

ThioTEPA has been designated as orphan drug by the European Medicines Agency on January 29, 2007, for the indication: "Conditioning treatment prior to haematopoietic progenitor cell transplantation". ThioTEPA has been later designated as orphan drug by the United States Food and Drug Administration (FDA) on April 2, 2007, for the same indication. The applicant of both these orphan drug designations was the italian company ADIENNE Pharma & Biotech, owner of the drug TEPADINA (INN: thiotepa).

Uses

It is mostly used to treat breast cancer, ovarian cancer, and bladder cancer. It is also used as conditioning for bone marrow transplantation. During surgery for ovarian cancer peritoneal washings should be done to remove any cancer cells. Microscopic examination of the fluid may indicate if tumour has spread to the peritoneum. Thiotepa may be left in the peritoneum to work as a chemotherapeutic agent.^[3] Thiotepa has been used in combinations with cyclophosphamide and carboplatin.^[4]

Its main toxicity is myelosuppression.The most serious complication of excessive therapy is bone marrow depression, causing leukopenia, thrombocytopenia, and anemia. If WBC count falls to 3,000/mm 3 or less, discontinue use. If the platelet count falls to 150,000/mm 3 , discontinue therapy.

In 2006 the National Cancer Institute recommended giving cisplastin and paclitaxel by both the intravenous and intraperitoneal route after ovarian cancer surgery.

References

External links

• TEPADINA (INN: Thiotepa)