Ifosfamide. Metabolic studies, new therapeutic approaches and new analogs.

Ifosfamide (IFO), an oxazaphosphorine-type anticancer alkylating agent, was found to be particularly useful in the treatment of a wide variety of neoplasm in adults and children. IFO is a positional isomer of cyclophosphamide (CPA) and was introduced into clinical practice in the 80s and has recently attracted much attention. Therapeutic application of high-dose IFO is limited by several side-effects; among them neurotoxicity and nephrotoxicity give the greatest concern. The presence of these side-effects is likely to be connected with the metabolism of this drug. In recent years there have been many studies aiming better understanding metabolism of this drug, employing new therapeutic approaches and preparing new analogs.