# Evofosfamide

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

## TL;DR

Evofosfamide was the most advanced hypoxia-activated drug, designed to kill the oxygen-starved tumour cells radiotherapy and chemotherapy miss, but it failed both of its phase 3 trials in 2015.

## Summary

Evofosfamide (TH-302), developed by Threshold Pharmaceuticals with Merck KGaA, showed promising responses in early trials. In 2015 both phase 3 trials missed their overall survival endpoints: MAESTRO with gemcitabine in pancreatic cancer and TH CR-406 with doxorubicin in soft-tissue sarcoma. Development largely stopped, though small studies with radiotherapy and immunotherapy continue, and the programme remains the reference case for why hypoxia targeting is hard: patients were not selected for hypoxia, and the drug's activation depends on oxygen levels that vary from hour to hour.

## Fields

- Kind: Treatment
- Status: negative
- Last checked: 2026-09-16
- Tags: radiation-wave3
- Code: TH-302
- Modality: Hypoxia-activated prodrug (small molecule alkylating agent)
- Mechanism: A nitroimidazole-linked prodrug that is inert in oxygenated tissue and releases the DNA-crosslinking agent bromo-isophosphoramide mustard only in the low-oxygen regions of tumours.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Evofosfamide

## Connected records

- cancers: [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Sarcomas (soft tissue, bone, GIST)](https://onco.cc/cancers/sarcoma/)
- technologies: [Tumour hypoxia: imaging and modification](https://onco.cc/technologies/tumour-hypoxia-modification/)
- companies: [Threshold Pharmaceuticals](https://onco.cc/companies/threshold-pharmaceuticals/)

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JSON: https://onco.cc/api/v1/entities/evofosfamide.json