Cyclophosphamide
One of the most widely used chemotherapy drugs: part of CHOP for lymphoma, AC for breast cancer, VAC for childhood sarcomas, and used to prepare patients for CAR-T and transplant.
Approved 1959. Backbone of CHOP/R-CHOP, AC/TC (breast), VDC/IE (Ewing), VAC (rhabdomyosarcoma), CVP, hyper-CVAD, EMA-CO; lymphodepletion before CAR-T; post-transplant cyclophosphamide for GVHD prophylaxis; low-dose metronomic use. Toxicities: myelosuppression, haemorrhagic cystitis (mesna), infertility, secondary leukaemia, cardiotoxicity at high dose.
- Medicare
- Part B or Part D
Oral anticancer drug with an injectable equivalent used for the same indication, so Medicare covers the oral form under Part B (the oral anticancer drug benefit) as well as under Part D; the pharmacy bills whichever applies. IV cyclophosphamide is Part B (HCPCS J9070).
- Commercial insurance
- covered on label
Multi-source generic; covered under the medical benefit without prior authorisation in most plans, as part of standard regimens.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B) · Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
- Notes
- Long-established generic: never subject to a technology appraisal; funded routinely through hospital formularies and NHS England systemic anti-cancer therapy protocols.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE search: cyclophosphamide. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 1959 | Lymphomas, leukaemias, multiple myeloma, breast, ovarian, neuroblastoma, retinoblastoma and other cancers |
Trials
topRecruiting now (live from ClinicalTrials.gov)
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This trial supplied the randomised proof that was missing for TIL therapy and showed academic centres can run cell-therapy phase 3 trials without industry. It supports TIL as a standard option after checkpoint inhibitor failure in melanoma and underpinned reimbursement in the Netherlands. The comparator, ipilimumab, is itself only modestly effective in this setting, and overall survival did not differ significantly.
Lifileucel proved that Steven Rosenberg's decades-old TIL concept could be industrialised into a licensed product and gave patients with checkpoint-refractory melanoma, who otherwise have few options, a chance of durable remission. It is the first cell therapy approved for any solid tumour. The treatment requires surgery to harvest tumour, hospitalisation for lymphodepletion and IL-2, and specialised centres, so its reach is limited.
Latest papers
topQuery for this drug: (TITLE:"Cyclophosphamide" OR ABSTRACT:"Cyclophosphamide" OR TITLE:"Cytoxan" OR ABSTRACT:"Cytoxan" OR TITLE:"Endoxan" OR ABSTRACT:"Endoxan") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Cyclophosphamide, not a curated reading list.
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