Details
Stereochemistry | ACHIRAL |
Molecular Formula | C6H12N3PS |
Molecular Weight | 189.218 |
Optical Activity | NONE |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
S=P(N1CC1)(N2CC2)N3CC3
InChI
InChIKey=FOCVUCIESVLUNU-UHFFFAOYSA-N
InChI=1S/C6H12N3PS/c11-10(7-1-2-7,8-3-4-8)9-5-6-9/h1-6H2
DescriptionCurator's Comment: Description was created based on several sources, including http://www.drugbank.ca/drugs/DB04572
Curator's Comment: Description was created based on several sources, including http://www.drugbank.ca/drugs/DB04572
N,N’N’-triethylenethiophosphoramide (ThioTEPA) is a cancer chemotherapeutic member of the alkylating agent group, now in use for over 50 years. It is a stable derivative of N,N’,N’’- triethylenephosphoramide (TEPA). The radiomimetic action of thiotepa is believed to occur through the release of ethylenimine radicals which, like irradiation, disrupt the bonds of DNA. One of the principal bond disruptions is initiated by alkylation of guanine at the N-7 position, which severs the linkage between the purine base and the sugar and liberates alkylated guanines. Thiotepa has been used in the palliation of a wide variety of neoplastic diseases. The more consistent results have been seen in: adenocarcinoma of the breast, adenocarcinoma of the ovary, superficial papillary carcinoma of the urinary bladder and for controlling intracavitary effusions secondary to diffuse or localized neoplastic diseases of various serosal cavities.
CNS Activity
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
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Target ID: CHEMBL2311221 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
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Primary | THIOTEPA Approved UseAdenocarcinoma of the breast. Launch Date1959 |
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Primary | THIOTEPA Approved UseAdenocarcinoma of the ovary. Launch Date1959 |
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Primary | THIOTEPA Approved UseFor the treatment of superficial papillary carcinoma of the urinary bladder Launch Date1959 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
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8.91 μg/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/11249051 |
200 mg/m² single, intravenous dose: 200 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
THIOTEPA plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
28.24 μg × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/11249051 |
200 mg/m² single, intravenous dose: 200 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
THIOTEPA plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE food status: UNKNOWN |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
4.15 h EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/11249051 |
200 mg/m² single, intravenous dose: 200 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
THIOTEPA plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE food status: UNKNOWN |
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2.55 h |
20 mg/m² unknown, intravenous dose: 20 mg/m² route of administration: Intravenous experiment type: UNKNOWN co-administered: |
THIOTEPA unknown | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
85% |
20 mg/m² unknown, intravenous dose: 20 mg/m² route of administration: Intravenous experiment type: UNKNOWN co-administered: |
THIOTEPA unknown | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
65 mg/m2 1 times / 3 weeks multiple, intravenous MTD Dose: 65 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 65 mg/m2, 1 times / 3 weeks Sources: Page: p.3172 |
unhealthy, 25-74 n = 8 Health Status: unhealthy Condition: Cancer Age Group: 25-74 Sex: M+F Population Size: 8 Sources: Page: p.3172 |
Other AEs: Leukopenia, Thrombocytopenia... Other AEs: Leukopenia (grade 3, 25%) Sources: Page: p.3172Thrombocytopenia (grade 4, 12.5%) |
75 mg/m2 1 times / 3 weeks multiple, intravenous Studied dose Dose: 75 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 75 mg/m2, 1 times / 3 weeks Sources: Page: p.3172 |
unhealthy, 25-74 n = 7 Health Status: unhealthy Condition: Cancer Age Group: 25-74 Sex: M+F Population Size: 7 Sources: Page: p.3172 |
DLT: Leukopenia, Thrombocytopenia... Dose limiting toxicities: Leukopenia (grade 3, 28.6%) Sources: Page: p.3172Thrombocytopenia (grade 3, 28.6%) Thrombocytopenia (grade 4, 28.6%) |
750 mg/m2 2 times / day multiple, intravenous (total) MTD Dose: 750 mg/m2, 2 times / day Route: intravenous Route: multiple Dose: 750 mg/m2, 2 times / day Co-administed with:: Busulfan, p.o(30 mg/m(2); 4 times/day; 4 days) Sources: Page: p.453Etoposide. i.v.(800 mg/m(2); q.d; 3 days) |
unhealthy, 2–16 n = 6 Health Status: unhealthy Condition: Disseminated solid tumors Age Group: 2–16 Sex: M+F Population Size: 6 Sources: Page: p.453 |
Other AEs: Mucositis, Gastrointestinal toxicity... Other AEs: Mucositis (grade 3, 33.3%) Sources: Page: p.453Gastrointestinal toxicity (grade 3, 33.3%) |
60 mg/m2 1 times / month multiple, intravenous MTD Dose: 60 mg/m2, 1 times / month Route: intravenous Route: multiple Dose: 60 mg/m2, 1 times / month Co-administed with:: pentoxifylline, p.o(1600 mg; t.i.d; 4 doses) Sources: Page: p.793 |
unhealthy, 30-76 n = 25 Health Status: unhealthy Condition: Breast cancer Age Group: 30-76 Sex: F Population Size: 25 Sources: Page: p.793 |
Other AEs: Leukopenia, Leukopenia... Other AEs: Leukopenia (grade 3, 16%) Sources: Page: p.793Leukopenia (grade 4, 8%) Thrombocytopenia (grade 3, 16%) Thrombocytopenia (grade 4, 12%) |
5 mg/kg 2 times / day multiple, intravenous Recommended Dose: 5 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 5 mg/kg, 2 times / day Co-administed with:: Busulfan, I.V(weight-based dose) Sources: Page: p.1Cyclophosphamide, I.V(40 mg/kg/day) |
unhealthy Health Status: unhealthy Condition: Class 3 Beta-Thalassemia Sources: Page: p.1 |
Disc. AE: Myelosuppression, Bone marrow failure... AEs leading to discontinuation/dose reduction: Myelosuppression (severe) Sources: Page: p.1Bone marrow failure (severe) Disorder fetal |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Leukopenia | grade 3, 25% | 65 mg/m2 1 times / 3 weeks multiple, intravenous MTD Dose: 65 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 65 mg/m2, 1 times / 3 weeks Sources: Page: p.3172 |
unhealthy, 25-74 n = 8 Health Status: unhealthy Condition: Cancer Age Group: 25-74 Sex: M+F Population Size: 8 Sources: Page: p.3172 |
Thrombocytopenia | grade 4, 12.5% | 65 mg/m2 1 times / 3 weeks multiple, intravenous MTD Dose: 65 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 65 mg/m2, 1 times / 3 weeks Sources: Page: p.3172 |
unhealthy, 25-74 n = 8 Health Status: unhealthy Condition: Cancer Age Group: 25-74 Sex: M+F Population Size: 8 Sources: Page: p.3172 |
Leukopenia | grade 3, 28.6% DLT |
75 mg/m2 1 times / 3 weeks multiple, intravenous Studied dose Dose: 75 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 75 mg/m2, 1 times / 3 weeks Sources: Page: p.3172 |
unhealthy, 25-74 n = 7 Health Status: unhealthy Condition: Cancer Age Group: 25-74 Sex: M+F Population Size: 7 Sources: Page: p.3172 |
Thrombocytopenia | grade 3, 28.6% DLT |
75 mg/m2 1 times / 3 weeks multiple, intravenous Studied dose Dose: 75 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 75 mg/m2, 1 times / 3 weeks Sources: Page: p.3172 |
unhealthy, 25-74 n = 7 Health Status: unhealthy Condition: Cancer Age Group: 25-74 Sex: M+F Population Size: 7 Sources: Page: p.3172 |
Thrombocytopenia | grade 4, 28.6% DLT |
75 mg/m2 1 times / 3 weeks multiple, intravenous Studied dose Dose: 75 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 75 mg/m2, 1 times / 3 weeks Sources: Page: p.3172 |
unhealthy, 25-74 n = 7 Health Status: unhealthy Condition: Cancer Age Group: 25-74 Sex: M+F Population Size: 7 Sources: Page: p.3172 |
Gastrointestinal toxicity | grade 3, 33.3% | 750 mg/m2 2 times / day multiple, intravenous (total) MTD Dose: 750 mg/m2, 2 times / day Route: intravenous Route: multiple Dose: 750 mg/m2, 2 times / day Co-administed with:: Busulfan, p.o(30 mg/m(2); 4 times/day; 4 days) Sources: Page: p.453Etoposide. i.v.(800 mg/m(2); q.d; 3 days) |
unhealthy, 2–16 n = 6 Health Status: unhealthy Condition: Disseminated solid tumors Age Group: 2–16 Sex: M+F Population Size: 6 Sources: Page: p.453 |
Mucositis | grade 3, 33.3% | 750 mg/m2 2 times / day multiple, intravenous (total) MTD Dose: 750 mg/m2, 2 times / day Route: intravenous Route: multiple Dose: 750 mg/m2, 2 times / day Co-administed with:: Busulfan, p.o(30 mg/m(2); 4 times/day; 4 days) Sources: Page: p.453Etoposide. i.v.(800 mg/m(2); q.d; 3 days) |
unhealthy, 2–16 n = 6 Health Status: unhealthy Condition: Disseminated solid tumors Age Group: 2–16 Sex: M+F Population Size: 6 Sources: Page: p.453 |
Leukopenia | grade 3, 16% | 60 mg/m2 1 times / month multiple, intravenous MTD Dose: 60 mg/m2, 1 times / month Route: intravenous Route: multiple Dose: 60 mg/m2, 1 times / month Co-administed with:: pentoxifylline, p.o(1600 mg; t.i.d; 4 doses) Sources: Page: p.793 |
unhealthy, 30-76 n = 25 Health Status: unhealthy Condition: Breast cancer Age Group: 30-76 Sex: F Population Size: 25 Sources: Page: p.793 |
Thrombocytopenia | grade 3, 16% | 60 mg/m2 1 times / month multiple, intravenous MTD Dose: 60 mg/m2, 1 times / month Route: intravenous Route: multiple Dose: 60 mg/m2, 1 times / month Co-administed with:: pentoxifylline, p.o(1600 mg; t.i.d; 4 doses) Sources: Page: p.793 |
unhealthy, 30-76 n = 25 Health Status: unhealthy Condition: Breast cancer Age Group: 30-76 Sex: F Population Size: 25 Sources: Page: p.793 |
Thrombocytopenia | grade 4, 12% | 60 mg/m2 1 times / month multiple, intravenous MTD Dose: 60 mg/m2, 1 times / month Route: intravenous Route: multiple Dose: 60 mg/m2, 1 times / month Co-administed with:: pentoxifylline, p.o(1600 mg; t.i.d; 4 doses) Sources: Page: p.793 |
unhealthy, 30-76 n = 25 Health Status: unhealthy Condition: Breast cancer Age Group: 30-76 Sex: F Population Size: 25 Sources: Page: p.793 |
Leukopenia | grade 4, 8% | 60 mg/m2 1 times / month multiple, intravenous MTD Dose: 60 mg/m2, 1 times / month Route: intravenous Route: multiple Dose: 60 mg/m2, 1 times / month Co-administed with:: pentoxifylline, p.o(1600 mg; t.i.d; 4 doses) Sources: Page: p.793 |
unhealthy, 30-76 n = 25 Health Status: unhealthy Condition: Breast cancer Age Group: 30-76 Sex: F Population Size: 25 Sources: Page: p.793 |
Disorder fetal | Disc. AE | 5 mg/kg 2 times / day multiple, intravenous Recommended Dose: 5 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 5 mg/kg, 2 times / day Co-administed with:: Busulfan, I.V(weight-based dose) Sources: Page: p.1Cyclophosphamide, I.V(40 mg/kg/day) |
unhealthy Health Status: unhealthy Condition: Class 3 Beta-Thalassemia Sources: Page: p.1 |
Bone marrow failure | severe Disc. AE |
5 mg/kg 2 times / day multiple, intravenous Recommended Dose: 5 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 5 mg/kg, 2 times / day Co-administed with:: Busulfan, I.V(weight-based dose) Sources: Page: p.1Cyclophosphamide, I.V(40 mg/kg/day) |
unhealthy Health Status: unhealthy Condition: Class 3 Beta-Thalassemia Sources: Page: p.1 |
Myelosuppression | severe Disc. AE |
5 mg/kg 2 times / day multiple, intravenous Recommended Dose: 5 mg/kg, 2 times / day Route: intravenous Route: multiple Dose: 5 mg/kg, 2 times / day Co-administed with:: Busulfan, I.V(weight-based dose) Sources: Page: p.1Cyclophosphamide, I.V(40 mg/kg/day) |
unhealthy Health Status: unhealthy Condition: Class 3 Beta-Thalassemia Sources: Page: p.1 |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
no | ||||
strong [Ki 4.8 uM] | likely (co-administration study) Comment: noncompetitive inhibition. Ki value obtained using HLM; may increase the exposure of drugs that are substrates of CYP2B6 in patients; however, the clinical relevance of this in vitro interaction is unknown Sources: https://pubmed.ncbi.nlm.nih.gov/11950782/ |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
yes | likely (co-administration study) Comment: Avoid coadministration of strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin, ritonavir) and strong CYP3A4 inducers (e.g., rifampin, phenytoin); exposure to thiotepa was significantly reduced (29%) when coadministered with phenytoin (CYP inducer) Page: 10.0 |
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yes | weak (co-administration study) Comment: exposure to thiotepa was significantly reduced (29%) when coadministered with phenytoin (CYP inducer); Page: 10.0 |
PubMed
Title | Date | PubMed |
---|---|---|
Severe pancytopenia associated with the use of intravesical thio-TEPA. | 1967 Oct |
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[Arsenic trioxide inhibition of the thiophosphamide induction of mutations in mouse germ and somatic cells]. | 1984 Feb |
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Severe polyneuropathy and motor loss after intrathecal thiotepa combination chemotherapy: description of two cases. | 1990 Oct |
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The role of human glutathione S-transferase isoenzymes in the formation of glutathione conjugates of the alkylating cytostatic drug thiotepa. | 1995 Apr 15 |
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Therapeutic activity of CPT-11, a DNA-topoisomerase I inhibitor, against peripheral primitive neuroectodermal tumour and neuroblastoma xenografts. | 1996 Aug |
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Transforming growth factor-beta 1 overexpression produces drug resistance in vivo: reversal by decorin. | 1997 Nov-Dec |
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[A comparative study of thio-tepa and mitomycin C in the treatment of pterygium. Preliminary results]. | 1998 Feb |
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Phase I trial of sequential high-dose chemotherapy with escalating dose paclitaxel, melphalan, and cyclophosphamide, thiotepa, and carboplatin with peripheral blood progenitor support in women with responding metastatic breast cancer. | 1998 Jul |
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Myeloablative chemotherapy for recurrent aggressive oligodendroglioma. | 2000 Apr |
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Pilot trial of cytoprotection with amifostine given with high-dose chemotherapy and autologous peripheral blood stem cell transplantation. | 2000 Aug |
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[Establishment of MRP-overexpression subline of bladder carcinoma and its MDR phenotype]. | 2000 Jul |
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Thiotepa and fludarabine (TT-FLUDA) as conditioning regimen in poor candidates for conventional allogeneic hemopoietic stem cell transplant. | 2001 Sep |
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Factors affecting progression-free survival in hormone-dependent metastatic breast cancer patients receiving high-dose chemotherapy and hematopoietic progenitor cell transplantation: role of maintenance endocrine therapy. | 2002 May |
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Triethylenethiophosphoramide is a specific inhibitor of cytochrome P450 2B6: implications for cyclophosphamide metabolism. | 2002 May |
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Selective inhibition of CYP2B6-catalyzed bupropion hydroxylation in human liver microsomes in vitro. | 2004 Jun |
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Prediction of genotoxicity of chemical compounds by statistical learning methods. | 2005 Jun |
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High-dose chemotherapy with autologous stem-cell transplantation and hyperfractionated radiotherapy as first-line treatment of primary CNS lymphoma. | 2006 Aug 20 |
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Wound healing in patients with cancer. | 2008 Jan 11 |
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Impairment of APE1 function enhances cellular sensitivity to clinically relevant alkylators and antimetabolites. | 2009 Jun |
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Cytochrome P(450)-dependent toxic effects of primaquine on human erythrocytes. | 2009 Nov 15 |
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Excessive toxicity of once daily i.v. BU, melphalan and thiotepa followed by auto SCT on patients with non-Hodgkin's lymphoma. | 2010 Apr |
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Nicotinamide inhibits alkylating agent-induced apoptotic neurodegeneration in the developing rat brain. | 2011 |
|
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 |
Sample Use Guides
In Vivo Use Guide
Curator's Comment: Intracavitary Administration: The dosage recommended is 0.6 to 0.8 ug/kg. Administration is usually effected through the same tubing which is used to remove the fluid from the cavity involved.
Thiotepa may be given by rapid intravenous administration in
doses of 0.3 to 0.4 ug/kg. Doses should be given at 1 to 4 week intervals.
Route of Administration:
Intravenous
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/2106164
The cytotoxicity of thiotepa toward MCF-7 cells was markedly dependent on the presence of oxygen during the period of drug exposure, with a 3-log greater cell kill at 500 umol with cells that were normally oxygenated compared with hypoxic cells.
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Classification Tree | Code System | Code | ||
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IARC | Thiotepa | ||
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WHO-ATC |
L01AC01
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EU-Orphan Drug |
EU/3/06/424
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NCI_THESAURUS |
C292
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NDF-RT |
N0000175558
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LIVERTOX |
NBK548174
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EMA ASSESSMENT REPORTS |
TEPADINA (AUTHORIZED: HEMATOPOIETIC STEM CELL TRANSPLANTATION)
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NDF-RT |
N0000000236
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FDA ORPHAN DRUG |
237807
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WHO-VATC |
QL01AC01
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Code System | Code | Type | Description | ||
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1664000
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905Z5W3GKH
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2638
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100000082128
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D013852
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3258
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m10788
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PRIMARY | Merck Index | ||
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200-135-7
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6396
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Thiotepa
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DTXSID0021339
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881
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DB04572
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5453
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10473
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52-24-4
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C875
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CHEMBL671
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905Z5W3GKH
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thiotepa
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SUB10985MIG
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7622
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ACTIVE MOIETY