U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C24H30Cl2FN3O3.ClH
Molecular Weight 534.879
Optical Activity UNSPECIFIED
Defined Stereocenters 2 / 2
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of MELPHALAN FLUFENAMIDE HYDROCHLORIDE

SMILES

Cl.CCOC(=O)[C@H](CC1=CC=C(F)C=C1)NC(=O)[C@@H](N)CC2=CC=C(C=C2)N(CCCl)CCCl

InChI

InChIKey=ZCMWSKHHXLCVHI-VROPFNGYSA-N
InChI=1S/C24H30Cl2FN3O3.ClH/c1-2-33-24(32)22(16-18-3-7-19(27)8-4-18)29-23(31)21(28)15-17-5-9-20(10-6-17)30(13-11-25)14-12-26;/h3-10,21-22H,2,11-16,28H2,1H3,(H,29,31);1H/t21-,22-;/m0./s1

HIDE SMILES / InChI

Description
Curator's Comment: description was created based on several sources, including,http://www.nhs.uk/ipgmedia/National/Macmillan%20Cancer%20Support/assets/MelphalanMCS5pages.pdf http://www.bloodjournal.org/content/bloodjournal/100/1/224.full.pdf

Melphalan, also known as L-phenylalanine mustard, phenylalanine mustard, L-PAM, or L-sarcolysin, is a phenylalanine derivative of nitrogen mustard. Melphalan is a bifunctional alkylating agent which produces a number of DNA adducts with the DNA interstrand crosslink (ICL) considered to be the critical cytotoxic lesion. Melphalan is used to treat different cancers including myeloma, melanoma and ovarian cancer.

CNS Activity

Curator's Comment: Melphalan poorly penetrates the central nervous system.

Originator

Curator's Comment: This substance was synthesized simultaneously both at the Chester Beatty Research Institute and in the Soviet Union.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Palliative
ALKERAN

Approved Use

ALKERAN Tablets are indicated for the palliative treatment of multiple myeloma and for the palliation of non-resectable epithelial carcinoma of the ovary.

Launch Date

1964
Palliative
ALKERAN

Approved Use

ALKERAN Tablets are indicated for the palliative treatment of multiple myeloma and for the palliation of non-resectable epithelial carcinoma of the ovary.

Launch Date

1964
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
212 ng/mL
0.25 mg/kg single, oral
dose: 0.25 mg/kg
route of administration: Oral
experiment type: SINGLE
co-administered:
MELPHALAN plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
12.84 mg × h/L
200 mg/m² single, intravenous
dose: 200 mg/m²
route of administration: Intravenous
experiment type: SINGLE
co-administered:
MELPHALAN plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
498 ng × h/mL
0.25 mg/kg single, oral
dose: 0.25 mg/kg
route of administration: Oral
experiment type: SINGLE
co-administered:
MELPHALAN plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
1 h
0.25 mg/kg single, oral
dose: 0.25 mg/kg
route of administration: Oral
experiment type: SINGLE
co-administered:
MELPHALAN plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
70%
MELPHALAN plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
40 mg/m2 1 times / 3 weeks multiple, intravenous
Highest studied dose
Dose: 40 mg/m2, 1 times / 3 weeks
Route: intravenous
Route: multiple
Dose: 40 mg/m2, 1 times / 3 weeks
Sources: Page: p.60
unhealthy, 18–74
n = 7
Health Status: unhealthy
Condition: Advanced cancer
Age Group: 18–74
Sex: M+F
Population Size: 7
Sources: Page: p.60
DLT: Thrombocytopenia, Neutropenia...
Dose limiting toxicities:
Thrombocytopenia (grade 4, 57%)
Neutropenia (grade 4, 57%)
Sources: Page: p.60
30 mg/m2 1 times / 3 weeks multiple, intravenous
MTD
Dose: 30 mg/m2, 1 times / 3 weeks
Route: intravenous
Route: multiple
Dose: 30 mg/m2, 1 times / 3 weeks
Sources: Page: p.60
unhealthy, 18–74
n = 9
Health Status: unhealthy
Condition: Advanced cancer
Age Group: 18–74
Sex: M+F
Population Size: 9
Sources: Page: p.60
DLT: Thrombocytopenia, Neutropenia...
Dose limiting toxicities:
Thrombocytopenia (grade 4, 44%)
Neutropenia (grade 4, 44%)
Sources: Page: p.60
200 mg/m2 1 times / 70 days multiple, intravenous
MTD
Dose: 200 mg/m2, 1 times / 70 days
Route: intravenous
Route: multiple
Dose: 200 mg/m2, 1 times / 70 days
Sources: Page: p.248, 250
unhealthy, 33–65
n = 55
Health Status: unhealthy
Condition: Multiple myeloma
Age Group: 33–65
Sex: M+F
Population Size: 55
Sources: Page: p.248, 250
Disc. AE: Toxic reaction (NOS), Bacterial infection...
AEs leading to
discontinuation/dose reduction:
Toxic reaction (NOS) (grade 4, 1.8%)
Bacterial infection (grade 5, 3.6%)
Systemic herpes zoster infection (grade 5, 1.8%)
Sources: Page: p.248, 250
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
Disc. AE: Bone marrow depression, Hypersensitivity reaction...
AEs leading to
discontinuation/dose reduction:
Bone marrow depression (severe)
Hypersensitivity reaction (2%)
Anaphylaxis
Gastrointestinal toxicity
Nausea
Vomiting
Diarrhea
Mucositis oral
Fetal damage
Infertility
Sources: Page: p.1
AEs

AEs

AESignificanceDosePopulation
Neutropenia grade 4, 57%
DLT
40 mg/m2 1 times / 3 weeks multiple, intravenous
Highest studied dose
Dose: 40 mg/m2, 1 times / 3 weeks
Route: intravenous
Route: multiple
Dose: 40 mg/m2, 1 times / 3 weeks
Sources: Page: p.60
unhealthy, 18–74
n = 7
Health Status: unhealthy
Condition: Advanced cancer
Age Group: 18–74
Sex: M+F
Population Size: 7
Sources: Page: p.60
Thrombocytopenia grade 4, 57%
DLT
40 mg/m2 1 times / 3 weeks multiple, intravenous
Highest studied dose
Dose: 40 mg/m2, 1 times / 3 weeks
Route: intravenous
Route: multiple
Dose: 40 mg/m2, 1 times / 3 weeks
Sources: Page: p.60
unhealthy, 18–74
n = 7
Health Status: unhealthy
Condition: Advanced cancer
Age Group: 18–74
Sex: M+F
Population Size: 7
Sources: Page: p.60
Neutropenia grade 4, 44%
DLT
30 mg/m2 1 times / 3 weeks multiple, intravenous
MTD
Dose: 30 mg/m2, 1 times / 3 weeks
Route: intravenous
Route: multiple
Dose: 30 mg/m2, 1 times / 3 weeks
Sources: Page: p.60
unhealthy, 18–74
n = 9
Health Status: unhealthy
Condition: Advanced cancer
Age Group: 18–74
Sex: M+F
Population Size: 9
Sources: Page: p.60
Thrombocytopenia grade 4, 44%
DLT
30 mg/m2 1 times / 3 weeks multiple, intravenous
MTD
Dose: 30 mg/m2, 1 times / 3 weeks
Route: intravenous
Route: multiple
Dose: 30 mg/m2, 1 times / 3 weeks
Sources: Page: p.60
unhealthy, 18–74
n = 9
Health Status: unhealthy
Condition: Advanced cancer
Age Group: 18–74
Sex: M+F
Population Size: 9
Sources: Page: p.60
Toxic reaction (NOS) grade 4, 1.8%
Disc. AE
200 mg/m2 1 times / 70 days multiple, intravenous
MTD
Dose: 200 mg/m2, 1 times / 70 days
Route: intravenous
Route: multiple
Dose: 200 mg/m2, 1 times / 70 days
Sources: Page: p.248, 250
unhealthy, 33–65
n = 55
Health Status: unhealthy
Condition: Multiple myeloma
Age Group: 33–65
Sex: M+F
Population Size: 55
Sources: Page: p.248, 250
Systemic herpes zoster infection grade 5, 1.8%
Disc. AE
200 mg/m2 1 times / 70 days multiple, intravenous
MTD
Dose: 200 mg/m2, 1 times / 70 days
Route: intravenous
Route: multiple
Dose: 200 mg/m2, 1 times / 70 days
Sources: Page: p.248, 250
unhealthy, 33–65
n = 55
Health Status: unhealthy
Condition: Multiple myeloma
Age Group: 33–65
Sex: M+F
Population Size: 55
Sources: Page: p.248, 250
Bacterial infection grade 5, 3.6%
Disc. AE
200 mg/m2 1 times / 70 days multiple, intravenous
MTD
Dose: 200 mg/m2, 1 times / 70 days
Route: intravenous
Route: multiple
Dose: 200 mg/m2, 1 times / 70 days
Sources: Page: p.248, 250
unhealthy, 33–65
n = 55
Health Status: unhealthy
Condition: Multiple myeloma
Age Group: 33–65
Sex: M+F
Population Size: 55
Sources: Page: p.248, 250
Hypersensitivity reaction 2%
Disc. AE
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
Anaphylaxis Disc. AE
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
Diarrhea Disc. AE
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
Fetal damage Disc. AE
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
Gastrointestinal toxicity Disc. AE
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
Infertility Disc. AE
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
Mucositis oral Disc. AE
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
Nausea Disc. AE
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
Vomiting Disc. AE
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
Bone marrow depression severe
Disc. AE
100 mg/m2 1 times / day multiple, intravenous
Recommended
Dose: 100 mg/m2, 1 times / day
Route: intravenous
Route: multiple
Dose: 100 mg/m2, 1 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Multiple myeloma
Sources: Page: p.1
PubMed

PubMed

TitleDatePubMed
Prolonged apnea after succinylcholine in a case treated with cytostatics for cancer.
1972 Sep-Oct
[Diagnosis and treatment of plasma cell leukemia].
1973 Apr 27
Carcinoma of the breast. Occurence after treatment with melphalan for multiple myeloma.
1976 Oct 4
[Refractory anemia with partial myeloblastosis in multiple myeloma treated with melphalan].
1977 Apr 9-16
Cytomegalovirus pneumonia after treatment with melphalan and prednisone. Report of a case.
1978
Lymphocyte transformation studies in drug hypersensitivity.
1979 May 5
Drug testing using a soft agar stem cell assay on patient and xenograft tumor material.
1984 Sep
Melphalan-resistant multiple myeloma: results of treatment according to the M-2 protocol.
1985
Syndrome of inappropriate antidiuretic hormone secretion. A complication of high-dose intravenous melphalan.
1985 Jan 1
Altered pharmacokinetics in the mechanism of chemosensitization: effects of nitroimidazoles and other chemical modifiers on the pharmacokinetics, antitumour activity and acute toxicity of selected nitrogen mustards.
1986
L-phenylalanine mustard-dianhydrogalactitol and hyponatremia.
1986
Interferon alfa-2b/melphalan/prednisone in previously untreated patients with multiple myeloma: a phase I-II trial.
1987
Successful treatment of peripheral neuropathy with chemotherapy in osteosclerotic myeloma.
1987 May
[A case report of acute renal failure induced by melphalan in a patient with ovarian cancer].
1988 Nov
Prednisone mood disorder with associated catatonia.
1989 Jan-Mar
Cytogenetic abnormalities in acute leukemia complicating melphalan-treated multiple myeloma.
1990 Aug 1
[Enhancing factors in the cardiotoxicity of anthracyclines].
1990 Jan
[Hepatic veno-occlusive disease in a patient undergoing bone marrow autotransplant after busulfan and melphalan conditioning].
1990 Jan 27
Interaction of melphalan and dexamethasone in a human myeloma cell line.
1991 Dec
Multiple myeloma with coexistent myelofibrosis: improvement of myelofibrosis following recovery from multiple myeloma after treatment with melphalan and prednisolone.
1991 Sep-Oct
SWOG 8825: melphalan GM-CSF: a phase I study.
1992 Jan
[White blood cell lysis syndrome after autologous peripheral blood stem cell transplantation in the treatment of renal AL amyloidosis. Case report].
2006 Jun
The effect of intracellular ascorbate on the susceptibility of HL60 and Jurkat cells to chemotherapy agents.
2006 Oct
Fatal leukoencephalopathy after reduced-intensity allogeneic stem cell transplantation.
2007 Feb
Disseminated necrotizing leukoencephalopathy following low-dose oral methotrexate.
2007 Mar
Cross-linking of the DNA repair protein Omicron6-alkylguanine DNA alkyltransferase to DNA in the presence of antitumor nitrogen mustards.
2008 Apr
Pharmacologic profiling of human and rat cytochrome P450 1A1 and 1A2 induction and competition.
2008 Dec
Heterogeneity of human glioblastoma: glutathione-S-transferase and methylguanine-methyltransferase.
2008 Jul
Long-term risk of myelodysplasia in melphalan-treated patients with immunoglobulin light-chain amyloidosis.
2008 Sep
Cardiac toxicity of high-dose cyclophosphamide and melphalan in patients with multiple myeloma treated with tandem autologous hematopoietic stem cell transplantation.
2008 Sep
Cutaneous involvement in multiple myeloma and bortezomib.
2009 Nov
Efficacy and safety of once-weekly bortezomib in multiple myeloma patients.
2010 Dec 2
Uptake of 3-[125I]iodo-alpha-methyl-L-tyrosine into colon cancer DLD-1 cells: characterization and inhibitory effect of natural amino acids and amino acid-like drugs.
2010 Feb
Thalidomide-induced phrenic nerve paralysis.
2010 Feb
Glutathione S-transferase M1 inhibits dexamethasone-induced apoptosis in association with the suppression of Bim through dual mechanisms in a lymphoblastic leukemia cell line.
2010 Mar
Mechanisms of peripheral neuropathy associated with bortezomib and vincristine in patients with newly diagnosed multiple myeloma: a prospective analysis of data from the HOVON-65/GMMG-HD4 trial.
2010 Nov
Inhalation of alkylating mustard causes long-term T cell-dependent inflammation in airways and growth of connective tissue.
2011 Feb 27
Risk factors for, and reversibility of, peripheral neuropathy associated with bortezomib-melphalan-prednisone in newly diagnosed patients with multiple myeloma: subanalysis of the phase 3 VISTA study.
2011 Jan
Bone marrow osteoblast damage by chemotherapeutic agents.
2012
Efficient monitoring of in vivo pig-a gene mutation and chromosomal damage: summary of 7 published studies and results from 11 new reference compounds.
2012 Dec
Increased expression of VDAC1 sensitizes carcinoma cells to apoptosis induced by DNA cross-linking agents.
2012 May 1
Corticosteroid treatment inhibits airway hyperresponsiveness and lung injury in a murine model of chemical-induced airway inflammation.
2012 Nov 15
In vitro and in vivo antitumor activity of a novel alkylating agent, melphalan-flufenamide, against multiple myeloma cells.
2013 Jun 1
The novel alkylating prodrug melflufen (J1) inhibits angiogenesis in vitro and in vivo.
2013 Oct 1
FDA-approved drugs and other compounds tested as inhibitors of human glutathione transferase P1-1.
2013 Sep 5
Repairing of N-mustard derivative BO-1055 induced DNA damage requires NER, HR, and MGMT-dependent DNA repair mechanisms.
2015 Sep 22
In vitro and in vivo activity of melflufen (J1)in lymphoma.
2016 Apr 4
A novel alkylating agent Melflufen induces irreversible DNA damage and cytotoxicity in multiple myeloma cells.
2016 Aug
In vitro and in vivo anti-leukemic activity of the peptidase-potentiated alkylator melflufen in acute myeloid leukemia.
2017 Jan 24
Melflufen - a peptidase-potentiated alkylating agent in clinical trials.
2017 Sep 12
Patents

Sample Use Guides

In Vivo Use Guide
Curator's Comment: IV dose is 16 mg/m2
Phase 3 clinical study (OCEAN, OP-103). Melflufen 40 mg i.v. on Day 1 and dexamethasone 40 mg on Days 1, 8, 15 and 22 of each 28-day cycle.
Route of Administration: Intravenous
In Vitro Use Guide
Curator's Comment: RPMI-8226 (multiple myeloma) cells were treated with 10 uM or 100 uM of melphalan.
Melflufen showed activity with cytotoxic IC50-values in the submicromolar range (0.011-0.92 μM) in the cell lines. In the primary cultures melflufen yielded slightly lower IC50-values (2.7 nM to 0.55 μM). Treated cell lines exhibited a clear accumulation in the G2/M-phase of the cell cycle.
Name Type Language
MELPHALAN FLUFENAMIDE HYDROCHLORIDE
USAN  
Official Name English
L-PHENYLALANINE, 4-(BIS(2-CHLOROETHYL)AMINO)-L-PHENYLALANYL-4-FLUORO-, ETHYL ESTER, MONOHYDROCHLORIDE
Systematic Name English
J-1 HYDROCHLORIDE
Code English
MELFLUFEN
Common Name English
MELPHALAN FLUFENAMIDE HYDROCHLORIDE [ORANGE BOOK]
Common Name English
ETHYL (2S)-2-((2S)-2-AMINO-3-(4-(BIS(2-CHLOROETHYL)AMINO)PHENYL)PROPANAMIDO)-3-(4-FLUOROPHENYL)PROPANOATE, HYDROCHLORIDE (1:1)
Common Name English
MELPHALAN FLUFENAMIDE HYDROCHLORIDE [USAN]
Common Name English
PEPAXTO
Brand Name English
CK-1535
Code English
J1 HYDROCHLORIDE
Code English
MELPHALANYL-P-L-FLUOROPHENYLALANINE ETHYL ESTER HYDROCHLORIDE
Common Name English
MELFLUFEN HYDROCHLORIDE
Common Name English
Melphalan flufenamide hydrochloride [WHO-DD]
Common Name English
Classification Tree Code System Code
FDA ORPHAN DRUG 465314
Created by admin on Sat Dec 16 12:10:27 GMT 2023 , Edited by admin on Sat Dec 16 12:10:27 GMT 2023
Code System Code Type Description
NCI_THESAURUS
C175815
Created by admin on Sat Dec 16 12:10:27 GMT 2023 , Edited by admin on Sat Dec 16 12:10:27 GMT 2023
PRIMARY
USAN
GH-115
Created by admin on Sat Dec 16 12:10:27 GMT 2023 , Edited by admin on Sat Dec 16 12:10:27 GMT 2023
PRIMARY
FDA UNII
3412470A0V
Created by admin on Sat Dec 16 12:10:27 GMT 2023 , Edited by admin on Sat Dec 16 12:10:27 GMT 2023
PRIMARY
SMS_ID
100000178184
Created by admin on Sat Dec 16 12:10:27 GMT 2023 , Edited by admin on Sat Dec 16 12:10:27 GMT 2023
PRIMARY
RXCUI
2531370
Created by admin on Sat Dec 16 12:10:27 GMT 2023 , Edited by admin on Sat Dec 16 12:10:27 GMT 2023
PRIMARY
CAS
380449-54-7
Created by admin on Sat Dec 16 12:10:27 GMT 2023 , Edited by admin on Sat Dec 16 12:10:27 GMT 2023
PRIMARY
EVMPD
SUB193789
Created by admin on Sat Dec 16 12:10:27 GMT 2023 , Edited by admin on Sat Dec 16 12:10:27 GMT 2023
PRIMARY
PUBCHEM
70675838
Created by admin on Sat Dec 16 12:10:27 GMT 2023 , Edited by admin on Sat Dec 16 12:10:27 GMT 2023
PRIMARY