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Cyclophosphamide is an alkylating chemotherapy that damages DNA in dividing cells. It is part of CHOP for lymphoma, AC for breast cancer and VAC for childhood sarcomas, clears lymphocytes before CAR-T and prevents graft-versus-host disease after transplant; bladder bleeding, infertility and secondary leukaemia are its harms.
Approved 1959. Backbone of CHOP/R-CHOP, AC/TC (breast), VDC/IE (Ewing), VAC (rhabdomyosarcoma), CVP, hyper-CVAD, EMA-CO; lymphodepletion before CAR-T; post-transplant cyclophosphamide for GVHD prophylaxis; low-dose metronomic use. Toxicities: myelosuppression, haemorrhagic cystitis (mesna), infertility, secondary leukaemia, cardiotoxicity at high dose.
Activated by hepatic CYP2B6 to 4-hydroxycyclophosphamide/phosphoramide mustard, which cross-links DNA; acrolein by-product causes bladder toxicity.
1.Cyclophosphamide slips into a pocket on its target.
Oral anticancer drug with an injectable equivalent used for the same indication, so Medicare covers the oral form under Part B (the oral anticancer drug benefit) as well as under Part D; the pharmacy bills whichever applies. IV cyclophosphamide is Part B (HCPCS J9070).
Multi-source generic; covered under the medical benefit without prior authorisation in most plans, as part of standard regimens.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B) · Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE search: cyclophosphamide. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
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| Region | Year | Indication |
|---|---|---|
| US | 1959 | Lymphomas, leukaemias, multiple myeloma, breast, ovarian, neuroblastoma, retinoblastoma and other cancers |
Read for the class this product belongs to (cyclophosphamide) unless the answer names the product. Population figures from the cohorts named, not a prediction for one person. Blank where no source gives a recovery figure.
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The authors' conclusion is that ibrutinib-rituximab should be considered a new standard-of-care option for first-line treatment of older patients with mantle-cell lymphoma. The subgroup split means it is clearly better than R-CHOP and roughly equivalent to bendamustine-rituximab.
For fit younger patients treated in the intensive German tradition, BrECADD replaces escalated BEACOPP; how it compares with nivolumab-AVD from S1826 is the open question.
Axicabtagene ciloleucel as an option in relapsed follicular and marginal zone lymphoma. Compared with tisagenlecleucel in ELARA, the response rates are higher and the neurological toxicity substantially greater, which is the trade-off a patient and centre weigh.
This trial supplied the randomised proof that was missing for TIL therapy and showed academic centres can run cell-therapy phase 3 trials without industry. It supports TIL as a standard option after checkpoint inhibitor failure in melanoma and underpinned reimbursement in the Netherlands. The comparator, ipilimumab, is itself only modestly effective in this setting, and overall survival did not differ significantly.
Lifileucel proved that Steven Rosenberg's decades-old TIL concept could be industrialised into a licensed product and gave patients with checkpoint-refractory melanoma, who otherwise have few options, a chance of durable remission. It is the first cell therapy approved for any solid tumour. The treatment requires surgery to harvest tumour, hospitalisation for lymphodepletion and IL-2, and specialised centres, so its reach is limited.
R-CHOP remains the standard first-line regimen for diffuse large B-cell lymphoma. The trial is also the clearest lesson in the disease about adopting a regimen on single-arm data: dose-adjusted EPOCH-R had been used widely for a decade before this comparison existed.
Four cycles rather than six for young patients with limited-stage, low-risk aggressive B-cell lymphoma. The saving is two cycles of anthracycline and vincristine in people who will live for decades afterwards.
Confirmation, by a different route from HD18, that the interim scan can safely direct de-escalation in advanced Hodgkin lymphoma, and that most of the toxicity of escalated BEACOPP can be avoided in the 84 per cent of patients who respond early.
Query for this drug: (TITLE:"Cyclophosphamide" OR ABSTRACT:"Cyclophosphamide" OR TITLE:"Cytoxan" OR ABSTRACT:"Cytoxan" OR TITLE:"Endoxan" OR ABSTRACT:"Endoxan") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Cyclophosphamide, not a curated reading list.
Shares A Study of Treatment for Medulloblastoma Using Sodium Thiosulfate to Reduce Hearing Loss, Erythropoietin for Management of Anemia Caused by Chemotherapy, Tucidinostat in Combination With CHOP in Newly Diagnosed Peripheral T-Cell Lymphoma With Follicular Helper of T Cell Phenotype, EMA/CO for high-risk gestational trophoblastic tumours: results from a cohort of 272 patients and the tags generic, who-essential.
Shares Palifermin for the Reduction of Oral Mucositis in Single-dose Evaluation (PROMISE), EMA/CO for high-risk gestational trophoblastic tumours: results from a cohort of 272 patients, Clinical Study of XNW5004 Combined With CHOP/CHOEP in the Treatment of Untreated Peripheral T-Cell Lymphoma, EuroNet-PHL-C2 and the tags generic, who-essential.
Shares EMA/CO for high-risk gestational trophoblastic tumours: results from a cohort of 272 patients, Burkitt leukaemia, Intravascular large B-cell lymphoma, DBCG 82b and 82c and the tags generic, who-essential.
Shares AHOD1331, The cumulative dose that decides whether it comes back, AHL2011, PET-adapted treatment for newly diagnosed advanced Hodgkin lymphoma (AHL2011): a randomised, multicentre, non-inferiority, phase 3 study and the tags generic, who-essential.
Shares EMA/CO for high-risk gestational trophoblastic tumours: results from a cohort of 272 patients, FOXO1 fusion status and IRS group (rhabdomyosarcoma), COG AREN0533, Low-risk gestational trophoblastic neoplasia (FIGO score 0 to 6) and the tags generic, who-essential.
Shares Safety and Efficacy of Pembrolizumab (MK-3475) in Children and Young Adults With Classical Hodgkin Lymphoma (MK-3475-667/KEYNOTE-667), Therapy for Pediatric Relapsed or Refractory Precursor B-Cell Acute Lymphoblastic Leukemia and Lymphoma, AHL2011, PET-adapted treatment for newly diagnosed advanced Hodgkin lymphoma (AHL2011): a randomised, multicentre, non-inferiority, phase 3 study and the tags generic, who-essential.
Shares FOXO1 fusion status and IRS group (rhabdomyosarcoma), Group 3 and group 4 medulloblastoma (non-WNT/non-SHH), Rhabdomyosarcoma, High-risk neuroblastoma and the tags generic, who-essential.
Shares Safety and Efficacy Comparison of Docetaxel and Ixabepilone in Non Metastatic Poor Prognosis Breast Cancer, Sequential Administration of FE75C and Docetaxel Versus Docetaxel/Cyclophosphamide in HER-2 Negative, Node Positive Breast Cancer, Randomized Phase III Trial Comparing Sequential Administration of FE75C Followed by Docetaxel Versus Paclitaxel as Adjuvant Chemotherapy in Axillary Lymph Node (+) Breast Cancer, Six vs 12 Months of Trastuzumab With Docetaxel Following FEC as Adjuvant Treatment in N+ Breast Cancer and the tags generic, who-essential.