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Cyclophosphamide (Cyclophosphamide) - Summary

 
 



SUMMARY

Cyclophosphamide is a synthetic antineoplastic drug chemically related to the nitrogen mustards.

Cyclophosphamide is indicated for the following:

Malignant Diseases

Cyclophosphamide tablets, although effective alone in susceptible malignancies, are more frequently used concurrently or sequentially with other antineoplastic drugs. The following malignancies are often susceptible to cyclophosphamide treatment:

  1. Malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin’s disease, lyphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt’s lymphoma.
  2. Multiple myeloma.
  3. Leukemias: Chronic lymphocytic leukemia, chronic granulocytic leukemia (it is usually ineffective in acute blastic crisis), acute myelogenous and monocytic leukemia; acute lymphoblastic (stem-cell) leukemia in children (cyclophosphamide given during remission is effective in prolonging its duration).
  4. Mycosis fungoides (advanced disease).
  5. Neuroblastoma (disseminated disease).
  6. Adenocarcinoma of the ovary.
  7. Retinoblastoma.
  8. Carcinoma of the breast.
Nonmalignant Disease

Biopsy Proven “Minimal Change” Nephrotic Syndrome in Children

Cyclophosphamide tablets are useful in carefully selected cases of biopsy proven “minimal change” nephrotic syndrome in children but should not be used as primary therapy. In children whose disease fails to respond adequately to appropriate adrenocorticosteroid therapy or in whom the adrenocorticosteroid therapy produces or threatens to produce intolerable side effects, cyclophosphamide may induce a remission. Cyclophosphamide is not indicated for the nephrotic syndrome in adults or for any other renal disease.


See all Cyclophosphamide indications & dosage >>

NEWS HIGHLIGHTS

Published Studies Related to Cyclophosphamide

Comparison of high and low dose of cyclophosphamide in lupus nephritis patients: a long-term randomized controlled trial. [2011.09]
To evaluate the outcome of low doses of cyclophosphamide (Cyclo) therapy in lupus nephritis (LN) patients, we studied 117 biopsy-proven, de novo LN WHO class IV patients double-blinded and randomized in December 1997 to receive Cyclo in different doses; Group I (n=73) received Cyclo 10 mg/kg monthly for six months then every two months for 12 months...

Autologous non-myeloablative haemopoietic stem-cell transplantation compared with pulse cyclophosphamide once per month for systemic sclerosis (ASSIST): an open-label, randomised phase 2 trial. [2011.08.06]
BACKGROUND: Non-randomised studies of haemopoietic stem-cell transplantation (HSCT) in systemic sclerosis have shown improvements in lung function and skin flexibility but high treatment-related mortality. We aimed to assess safety and efficacy of autologous non-myeloablative HSCT in a phase 2 trial compared with the standard of care, cyclophosphamide... INTERPRETATION: Non-myeloablative autologous HSCT improves skin and pulmonary function in patients with systemic sclerosis for up to 2 years and is preferable to the current standard of care, but longer follow-up is needed. FUNDING: None. Copyright (c) 2011 Elsevier Ltd. All rights reserved.

Cyclophosphamide, thalidomide, and dexamethasone (CTD) as initial therapy for patients with multiple myeloma unsuitable for autologous transplantation. [2011.08.04]
As part of the randomized MRC Myeloma IX trial, we compared an attenuated regimen of cyclophosphamide, thalidomide, and dexamethasone (CTDa; n = 426) with melphalan and prednisolone (MP; n = 423) in patients with newly diagnosed multiple myeloma ineligible for autologous stem-cell transplantation...

Randomized multicenter trial of the effects of melanoma-associated helper peptides and cyclophosphamide on the immunogenicity of a multipeptide melanoma vaccine. [2011.07.20]
PURPOSE: This multicenter randomized trial was designed to test whether melanoma-associated helper peptides augment CD8(+) T-cell responses to a melanoma vaccine and whether cyclophosphamide (CY) pretreatment augments CD4(+) or CD8(+) T-cell responses to that vaccine... CONCLUSION: Melanoma-associated helper peptides paradoxically decreased CD8(+) T-cell responses to a melanoma vaccine (P < .001), and CY pretreatment had no immunologic or clinical effect. Prior work showed immunologic and clinical activity of 6MHP alone. Possible explanations for negative effects on CD8 responses include modulation of homing receptor expression or induction of antigen-specific regulatory T cells.

Prospective randomized trial of 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC) versus paclitaxel and FAC (TFAC) in patients with operable breast cancer: impact of taxane chemotherapy on locoregional control. [2011.07]
A previous randomized trial (CALGB 9344/Intergroup 0148) compared four cycles of adjuvant doxorubicin/cyclophosphamide (AC) to four cycles of AC plus four cycles of paclitaxel (AC + T) and demonstrated that the addition of paclitaxel improved locoregional control (LRC) in patients with node-positive breast cancer...

more studies >>

Clinical Trials Related to Cyclophosphamide

Phase III Comparison of Adjuvant Chemotherapy W/High-Dose Cyclophosphamide Plus Doxorubicin (AC) vs Sequential Doxorubicin Fol by Cyclophosphamide (A-C) in High Risk Breast Cancer Patients With 0-3 Positive Nodes (Intergroup, CALGB 9394) [Active, not recruiting]
To compare disease-free survival (DFS), overall survival (s), and toxicity of high-isk primary breast cancer patients with negative axillary lymph nodes or with one to three positive nodes treated with adjuvant high-dose chemotherapy with doxorubicin plus cyclophosphamide (AC), versus high-dose sequential chemotherapy with doxorubicin followed by cyclophosphamide (A-->C).

High-Dose Intravenous (IV) Cyclophosphamide Versus Monthly IV Cyclophosphamide [Active, not recruiting]
This study compares the effectiveness of high-dose cyclophosphamide treatment with the "gold standard" treatment, monthly intravenous (IV) cyclophosphamide, in people with moderate to severe lupus that does not respond to high-dose corticosteroid therapy. We will give patients either IV cyclophosphamide (750 milligrams per square meter of body surface area) monthly for 6 months, followed by quarterly maintenance therapy, or high-dose IV cyclophosphamide (50 milligrams per kilogram body weight per day) for the first four days of the study. Patients will be followed for 24 months after therapy.

Scleroderma Cyclophosphamide or Transplantation (SCOT) Study [Recruiting]
Primary Objectives:

1. To evaluate the potential benefit of high-dose immunosuppressive therapy as treatment for severe SSc by comparing event- free survival (EFS) after HDIT followed by stem cell transplantation with cyclophosphamide therapy. Event- free survival will be defined as survival without death or significant organ damage. An event based on organ dysfunction must be documented on at least 2 occasions >/= 3 months apart, or sustained for a 3-month period.

2. Mandatory research blood draws to evaluate mechanistic measures of immune recovery and reconstitution with clinical correlative studies

Secondary Objectives:

1. To evaluate and compare safety of HDIT transplantation and pulse cyclophosphamide, as evidenced by regimen-related toxicities, infectious complications, treatment-related mortality, overall total mortality, and time to engraftment.

2. To evaluate and compare disease responses after HDIT transplantation and pulse cyclophosphamide assessing skin disease by modified Rodnan Skin Score (mRSS), pulmonary function as measured by DLCO and FVC, Modified Health Assessment Questionnaire (SHAQ), and Quality of Life using Short Form-36 (SF-36).

3. To evaluate treatment effect on disease activation/progression as indicated by measures of cardiac, pulmonary, and renal status as well as skin integrity, gastrointestinal disease, health assessment (SHAQ), use of concomitant DMARDs, and occurrence of myositis.

A Study of ZYC300 Administered With Cyclophosphamide Pre-Dosing [Active, not recruiting]
ZYC300 is a plasmid DNA formulated within biodegradable microencapsulated particles. The purpose of this study is to evaluate the feasibility, safety, and tolerability of administering ZYC300 with a standard chemotherapy drug called Cyclophosphamide (Cytoxan). This is the first time that ZYC300 and Cyclophosphamide will be given together. Cyclophosphamide is a chemotherapy drug approved by the FDA that has been used for many years in many different kinds of cancer. In this trial the study drug will be used to boost the immune system. Sometimes the immune system cannot fight infected or abnormal cells because of other cells called T reg cells. The T reg cells limit the immune systems attack on infected or abnormal cells. In this study, the hope is that Cyclophosphamide will inhibit the T regs cells so that the ZYC300 can work better to attack the cancer cells

A Three Arm Study of Adriamycin, Cyclophosphamide Plus Docetaxel vs Adriamycin Plus Cyclophosphamide Followed By Paclitaxel vs Adriamycin Plus Cyclophosphamide Followed By Paclitaxel and Gemcitabine in Adjuvant Breast Cancer [Active, not recruiting]
Determine whether a regimen of dose-dense doxorubicin and cyclophosphamide followed by dose-dense paclitaxel and gemcitabine will be superior to a regimen of docetaxel, doxorubicin and cyclophosphamide as well as to a regimen of dose-dense doxorubicin and cyclophosphamide followed by dose-dense paclitaxel alone.

more trials >>

Reports of Suspected Cyclophosphamide Side Effects

Febrile Neutropenia (521)Neutropenia (401)Pyrexia (278)Infection (257)Pneumonia (246)Anaemia (235)Death (204)Thrombocytopenia (204)Sepsis (196)Nausea (171)more >>


Page last updated: 2011-12-09

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