II. Indications

  1. FDA Approved (replaced by newer agents for these indications)
    1. Breast Adenocarcinoma
    2. Ovarian Adenocarcinoma
    3. Bladder Superficial Papillary Carcinoma
    4. Hematopoetic Stem Cell Transplant (combined with other agents for pediatric class 3 Beta Thalassemia)
  2. Off-Label
    1. Hematopoetic Stem Cell Transplant (for CNS neoplasms)
    2. Leptomeningeal Metastases (administered via intrathecal route)
    3. Lymphoma

III. Mechanism

  1. Aziridine alkylating Antineoplastic Agent
    1. Derived from triethylenephosphoramide (TEPA)
    2. Prodrug that metabolizes in vivo to active ethylenimine groups
  2. Ethylenimine groups bind DNA at guanine's N7 position
    1. Cross-links DNA, blocks cell growth and division

IV. Medications

  1. Lypholized powder for injection: 15 mg, 100 mg

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Alopecia
  2. Bone Marrow Suppression
  3. Secondary Malignancy
  4. Impaired future fertility

VII. Safety

  1. Avoid in Lactation
  2. Avoid in Pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count

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Related Studies

Ontology: Thiotepa (C0039871)

Definition (NCI) A synthetic alkylating agent. Related to nitrogen mustard, thiotepa alkylates and crosslinks DNA, resulting in the inhibition of DNA replication. (NCI04)
Definition (NCI_NCI-GLOSS) An anticancer drug that belongs to the family of drugs called alkylating agents.
Definition (MSH) A very toxic alkylating antineoplastic agent also used as an insect sterilant. It causes skin, gastrointestinal, CNS, and bone marrow damage. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), thiotepa may reasonably be anticipated to be a carcinogen (Merck Index, 11th ed).
Definition (CSP) alkylating agent used as an antineoplastic in the treatment of carcinoma of the breast, ovary, and bladder, malignant infusions and lymphomas.
Definition (PDQ) A synthetic alkylating agent. Related to nitrogen mustard, thiotepa alkylates and crosslinks DNA, resulting in the inhibition of DNA replication. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42933&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42933&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C875" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Hazardous or Poisonous Substance (T131) , Organophosphorus Compound (T115)
MSH D013852
SnomedCT 387508004, 88997008
English Thio Tepa, Thio-Tepa, Thiophosphamide, Triethylenethiophosphoramide, Tris(1-aziridinyl)phosphine Sulfide, Aziridine, 1,1',1''-phosphinothioylidynetris-, thiotepa, 1,1',1"-phosphinothioylidynetrisaziridine, N,N',N''-triethylenethiophosphoramide, tris(1-aziridinyl)phosphine sulfide, 1,1',1''-Phosphinothioyldynetrisaziridine, Thiophosphoramide, thiotepa (medication), THIOTEPA, Thiotepa [Chemical/Ingredient], N,N', N''-Triethylenethiophosphoramide, Triethylene thiophosphoramide, 1,1',1''-Phosphinothioylidynetrisaziridine, Tris(1-aziridinyl)phosphine sulfide, TESPA, TSPA, Thiotepa (product), Thiotepa (substance), triethylene thiophosphoramide, triethylenethiophosphoramide, Thiofosfamide, Triethylene Thiophosphoramide, Thiotepa
Swedish Tiotepa
Czech thiotepa
Finnish Tiotepa
Russian TEPA, TRIETILENTIOFOSFORAMID, TIOTEF, TIOFOSFAMID, ТЕПА, ТИОТЭФ, ТИОФОСФАМИД, ТРИЭТИЛЕНТИОФОСФОРАМИД
Japanese トリエチレンチオホスホラミド, チオホスファミド, チオテパ, チオフォスファミド
Polish Tiotepa
Spanish tiotepa (producto), tiotepa (sustancia), tiotepa, trietilentiofosforamida, Tiofosfamida, Tio-TEPA, Tiotepa, Trietilenotiofosforamida
French Thiophosphamide, Thiotépa
German Thio-Tepa, Thiophosphamid, Thiotepa, Triethylenthiophosphoramid
Italian TioTepa
Portuguese Tiofosfamida, Tio-TEPA, Tiotepa, Trietilenotiofosforamida