Motixafortide

Motixafortide, sold under the brand name Aphexda, is a medication used for the treatment of multiple myeloma.^[1] Motixafortide is a hematopoietic stem cell mobilizer and a CXCR4 antagonist.^[1] It is given by subcutaneous injection.^[1]

Motixafortide

Clinical data
Trade names	Aphexda
Other names	BL-8040
AHFS/Drugs.com	Monograph
License data	US DailyMed: Motixafortide
Routes of administration	Subcutaneous
Drug class	Antineoplastic
ATC code	L03AX23 (WHO)
Legal status
Legal status	US: ℞-only[1][2]
Identifiers
CAS Number	664334-36-5 as acetate: 2639893-42-6
PubChem CID	91865076
DrugBank	DB14939
ChemSpider	64854351
UNII	DA9G065962 as acetate: 3ZPX60DV8A
KEGG	D12281 as acetate: D12282
ChEBI	CHEBI:145536
Chemical and physical data
Formula	C97H144FN33O19S2
Molar mass	2159.55 g·mol−1

The most common side effects include injection site reactions, pruritus, flushing, and back pain.^[3]

Motixafortide was approved for medical use in the United States in September 2023.^[3][4][5]

Medical uses

Motixafortide is indicated, in combination with filgrastim, a granulocyte-colony stimulating factor (G-CSF), to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in people with multiple myeloma.^[1][3][4]

Adverse effects

Motixafortide can cause injection site reactions, anaphylactic shock, and hypersensitivity reactions.^[3] Tumor cell mobilization in people with leukemia, leukocytosis, potential for tumor cell mobilization, and embryo-fetal toxicity can also be caused by motixafortide.^[3]

History

The US Food and Drug Administration (FDA) approved motixafortide based on evidence from the GENESIS study, a double-blind, placebo-controlled study, in which 122 participants with multiple myeloma, due to undergo autologous transplantation, were randomized 2:1 to receive motixafortide 1.25 mg/kg with granulocyte-colony stimulating factor (N=80) or placebo with granulocyte-colony stimulating factor (N=42) for mobilization of hematopoietic stem cells for collection and apheresis.^[3] This one trial evaluated the benefit and side effects of motixafortide in participants.^[3] The trial was conducted at 21 sites in five countries including Italy, Hungary, Germany, Spain, and the United States.^[3] There were 78 participants included in the trial from the United States, and 44 participants included from sites outside of the United States.^[3] The GENESIS trial was used to assess efficacy and safety.^[3]

Society and culture

Names

Motixafortide is the international nonproprietary name.^[6]