# Amifostine

Source: https://onco.cc/drugs/amifostine/  
OnCo record `amifostine` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Amifostine (Ethyol) is an infusion given just before chemotherapy or radiotherapy to shield the kidneys from cisplatin and the salivary glands from radiation, reducing dry mouth after head and neck treatment.

## Summary

Amifostine was approved in December 1995 to reduce cumulative renal toxicity from repeated cisplatin in advanced ovarian cancer and in 1999 to reduce moderate to severe xerostomia during post-operative radiotherapy for head and neck cancer when the field includes much of the parotid glands, on randomised trials in each setting. Concern that a radioprotector might also shield tumours, together with nausea, hypotension during infusion and skin reactions, has confined it to selected patients, and intensity-modulated radiotherapy has largely replaced it for salivary sparing. Guidelines (ASCO, MASCC) list it as an option rather than a standard.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-10
- Also known as: WR-2721
- Tags: nci-list; supportive
- Brand: Ethyol
- Modality: Cytoprotective thiol prodrug
- Mechanism: Dephosphorylated by alkaline phosphatase, which is more abundant in normal tissue, to the free thiol WR-1065 that scavenges reactive oxygen species and binds cisplatin metabolites, protecting kidney and salivary tissue.
- Approvals: US 1995: Reduction of cumulative cisplatin renal toxicity in advanced ovarian cancer; US 1999: Reduction of moderate to severe xerostomia from post-operative radiotherapy for head and neck cancer

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Amifostine
- US label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=amifostine
- NCI drug page: https://www.cancer.gov/about-cancer/treatment/drugs/amifostine

## Connected records

- cancers: [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [Ovarian cancer](https://onco.cc/cancers/ovarian/)
- technologies: [Dry mouth, teeth and taste after head and neck radiotherapy](https://onco.cc/technologies/dry-mouth-teeth-after-head-neck-radiotherapy/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [Radioprotectors and normal-tissue sparing drugs](https://onco.cc/technologies/radioprotectors/)
- trials: [A Phase 1 Study to Evaluate Safety and Efficacy of XER-001 (Amifostine for Nasoduodenal Delivery) in Combination With Sterotactic Body Radiotherapy for Treatment in Patients With Locally Advanced Pancreatic Cancer.](https://onco.cc/trials/nct07157033/)
- roadmaps: [Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH](https://onco.cc/roadmaps/radiation-roadmap/)

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