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 |
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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 |
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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 |
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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 |
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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 |
---|---|---|
[Spontaneously cured pancytopenia due to intravesical thio-tepa, apropos of one case]. | 1973 Dec |
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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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Biotransformation of N,N',N''-triethylenethiophosphoramide: oxidative desulfuration to yield N,N',N''-triethylenephosphoramide associated with suicide inactivation of a phenobarbital-inducible hepatic P-450 monooxygenase. | 1990 Feb 1 |
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Intravesical thiotepa-induced eosinophilic cystitis. | 1995 Nov |
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[Paraplegia following intrathecal chemotherapy]. | 1996 Jun 22 |
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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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Thiotepa-associated cardiomyopathy during blood or marrow transplantation: association with the female sex and cardiac risk factors. | 1999 |
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Veno-occlusive disease of the liver after busulfan, melphalan, and thiotepa conditioning therapy: incidence, risk factors, and outcome. | 1999 |
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Inhibitory effects of combinations of HER-2/neu antibody and chemotherapeutic agents used for treatment of human breast cancers. | 1999 Apr 1 |
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Hprt mutant frequency and molecular analysis of Hprt mutations in Fischer 344 rats treated with thiotepa. | 1999 Feb |
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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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Chemistry, pharmacology and pharmacokinetics of N,N',N" -triethylenethiophosphoramide (ThioTEPA). | 2000 Aug |
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High-dose carmustine, thiotepa and etoposide followed by autologous bone marrow rescue for the treatment of high risk central nervous system tumors. | 2000 Jul |
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Susceptibility to drug-induced apoptosis correlates with differential modulation of Bad, Bcl-2 and Bcl-xL protein levels. | 2000 Jun |
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Individualizing high-dose oral busulfan: prospective dose adjustment in a pediatric population undergoing allogeneic stem cell transplantation for advanced hematologic malignancies. | 2000 Sep |
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Retrovirus-mediated expression of the base excision repair proteins, formamidopyrimidine DNA glycosylase or human oxoguanine DNA glycosylase, protects hematopoietic cells from N,N',N"-triethylenethiophosphoramide (thioTEPA)-induced toxicity in vitro and in vivo. | 2001 Jul 1 |
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Protection of mammalian cells against chemotherapeutic agents thiotepa, 1,3-N,N'-bis(2-chloroethyl)-N-nitrosourea, and mafosfamide using the DNA base excision repair genes Fpg and alpha-hOgg1: implications for protective gene therapy applications. | 2001 Mar |
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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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[Effect of bcl-2 antisense oligonucleotides on multidrug resistance of cultured uveal melanoma cells]. | 2003 Feb |
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Cardiac toxicity observed in association with high-dose cyclophosphamide-based chemotherapy for metastatic breast cancer. | 2004 Aug |
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Prediction of genotoxicity of chemical compounds by statistical learning methods. | 2005 Jun |
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Efficacy of high-dose alkylating chemotherapy in HER2/neu-negative breast cancer. | 2006 Apr |
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The monoterpenoids citral and geraniol are moderate inhibitors of CYP2B6 hydroxylase activity. | 2008 Aug 11 |
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Wound healing in patients with cancer. | 2008 Jan 11 |
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Zebrafish (Danio rerio) embryos as a model for testing proteratogens. | 2011 Mar 15 |
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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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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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