BIOLOGICAL SIGNIFICANCE

Ifosfamide and Mesna is an antineoplastic and urinary protectant combination. It works by stopping the growth of certain cancers and by lowering the risk of bleeding in your bladder.

Mesna reacts with acrolein and other urotoxic metabolites of oxazaphosphorines (cyclophosphamide or ifosfamide) to form stable, non-urotoxic compounds. Mesna does not have any antitumour activity, nor does it appear to interfere with the antitumour activity of antineoplastic drugs.

CLINICAL USE

Used for treating certain types of cancer in combination with other medicines.

Prevention of hemorrhagic cystitis secondary to cyclophosphamide or ifosfamide.

Health Protection Branch approved indication.

MODE OF ACTION

Ifosfamide - A synthetic analogue of the nitrogen mustard cyclophosphamide with antineoplastic activity. Ifosfamide alkylates and forms DNA crosslink’s, thereby preventing DNA strand separation and DNA replication. This agent is a prodrug that must be activated through hydroxylation by hepatic microsomal enzymes. (NCI04)

Mesna - A sulfhydryl compound that is used to reduce the incidence of hemorrhagic cystitis associated with certain chemotherapeutic agents. Mesna is converted to a free thiol compound in the kidney, where it binds to and inactivates acrolein and other urotoxic metabolites of ifosfamide and cyclophosphamide, thereby reducing their toxic effects on the urinary tract during urinary excretion. (NCI04)

STRUCTURE: