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Edelfosine
Names
	Systematic IUPAC name 2-Methoxy-3-(octadecyloxy)propyl 2-(trimethylazaniumyl)ethyl phosphate
	Other names ET-18-O-CH3; 1-octadecyl-2-O-methyl-glycero-3-phosphocholine
Identifiers
CAS Number	70641-51-9 ;
3D model (JSmol)	Interactive image;
ChEBI	CHEBI:78649 ;
ChEMBL	ChEMBL107514 ;
ChemSpider	1350 ;
PubChem CID	1392;
UNII	1Y6SNA8L5S ;
CompTox Dashboard (EPA)	DTXSID20922896 DTXSID9045766, DTXSID20922896 ;
	InChI InChI=1S/C27H58NO6P/c1-6-7-8-9-10-11-12-13-14-15-16-17-18-19-20-21-23-32-25-27(31-5)26-34-35(29,30)33-24-22-28(2,3)4/h27H,6-26H2,1-5H3 Key: MHFRGQHAERHWKZ-UHFFFAOYSA-N ; InChI=1S/C27H58NO6P/c1-6-7-8-9-10-11-12-13-14-15-16-17-18-19-20-21-23-32-25-27(31-5)26-34-35(29,30)33-24-22-28(2,3)4/h27H,6-26H2,1-5H3;
	SMILES [O-]P(=O)(OCC(OC)COCCCCCCCCCCCCCCCCCC)OCC[N+](C)(C)C;
Properties
Chemical formula	C27H58NO6P
Molar mass	523.736 g·mol−1
	Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa). verify (what is ?) Infobox references

Edelfosine (ET-18-O-CH3; 1-octadecyl-2-O-methyl-glycero-3-phosphocholine)^[1] is a synthetic alkyl-lysophospholipid (ALP). It has antineoplastic (anti-cancer) effects.^[2]

Like all ALPs, it incorporates into the cell membrane and does not target the DNA. In many tumor cells, it causes selective apoptosis, sparing healthy cells.^[3] Edelfosine can activate the Fas/CD95 cell death receptor,^[4] can inhibit the MAPK/ERK mitogenic pathway and the Akt/protein kinase B (PKB) survival pathway.^[3]^[5] Aside from these plasma-level effects, edelfosine also affects gene expression by modulating the expression and activity of transcription factors.^[3]^[4]

It has immune modulating properties.^[6] These characteristics cause edelfosine also to affect HIV,^[7] parasitic,^[4]^[8] and autoimmune diseases.^[4]^[9]
It can complement classic anti-cancer drugs such as cisplatin.^[10]

It can be administered orally, intraperitoneally (IP) and intravenously (IV).

Edelfosine and other ALPs can be used for purging residual leukemic cells from bone marrow transplants.^[4]^[11]^[12]

It is an analog of miltefosine and perifosine.

In vitro and in vivo results

Edelfosine apoptosis-inducing abilities were studied with several types of cancer, among them multiple myeloma^[13] and non-small and small cell lung carcinoma cell lines.^[14] In vivo activity against human solid tumors in mice was shown against malignant gynecological tumor cells,^[3] like ovarian cancer, and against breast cancer. In vivo biodistribution studies demonstrated a “considerably higher” accumulation of Edelfosine in tumor cells than in other analyzed organs. It remained undergraded for a long time.^[3]^[15]^[16]

Clinical trials

Several clinical trials were conducted. Among them a phase I trials with solid tumors or leukemias and phase II with non-small-cell lung carcinomas (NSCLC).^[3] In a Phase II clinical trial for use of Edelfosine in treating leukemia with bone marrow transplants, it was found to be safe and 'possibly effective'.^[17] A phase II trial for the treatment of brain cancers was also reported.^[18] It showed encouraging results in stopping the growth of the tumor and a considerable improvement in the “quality of life” of the patients. A phase II trial on the effect of Edelfosine on advanced non-small-cell bronchogenic carcinoma had a “remarkable” “high proportion of patients with stationary tumor status” as result, stable disease after initial progression in 50% of the patients.^[17]^[19]

Toxicity

In animal tests the main toxic effect was gastrointestinal irritation. There were no significant negative systemic side effects observed. It showed that edelfosine can be given over a long period safely. Most important, in contrast to many DNA-directed anti-cancer drugs, no bone marrow toxicity was in vivo observed. Those findings in animals were confirmed in clinical trials. No mutagenic or cytogenetic effects were observed.^[3]^[20]

History

In the 1960s Herbert Fischer and Paul Gerhard in Freiburg, Germany, found that lysolecitin (2-lysophosphatidylcholine, LPC) increases the phagocytotic activity of macrophages. Since LPC had a short half-life, synthetic LPC-analogues were tested by Fischer, Otto Westphal, Hans Ulrich Weltzien and Paul Gerhard Munder. Unexpectedly, some of the substances showed strong anti-tumor activity and among them Edelfosine was the most effective. It is therefore considered to be the prototype of synthetic anti-cancer lipids.^[20]^[21]

References

^ "The antitumor ether lipid Edelfosine (ET-18-O-CH3) induces apoptosis in H-ras transformed human breast epithelial cells: by blocking ERK1/2 and p38 mitogenactivated protein kinases as potential targets" (PDF). 2008. Archived from the original (PDF) on 2011-08-11. {{cite journal}}: Cite journal requires |journal= (help)
^ Vogler, William R.; Liu, Jianguo; Volpert, Olga; Ades, Edwin W.; Bouck, Noel (1998). "The anticancer drug edelfosine is a potent inhibitor of neovascularization in vivo". Cancer Invest. 16 (8): 549–53. doi:10.3109/07357909809032884. PMID 9844614.
^ ^a ^b ^c ^d ^e ^f ^g Gajate, C; Mollinedo F (2002). "Biological Activities, Mechanisms of Action and Biomedical Prospect of the Antitumor Ether Phospholipid ET-18-OCH3 (Edelfosine), A Proapoptotic Agent in Tumor Cells". Current Drug Metabolism. 5 (3): 491–525. doi:10.2174/1389200023337225. hdl:10261/59536. PMID 12369895.
^ ^a ^b ^c ^d ^e Mollinedo, F; Gajate C; Martín-Santamaria S; Gago F (2004). "ET-18-OCH3 (edelfosine): a selective antitumour lipid targeting apoptosis through intracellular activation of Fas/CD95 death receptor". Current Medicinal Chemistry. 11 (24): 3163–84. doi:10.2174/0929867043363703. PMID 15579006.
^ Ruiter, GA; Zerp SF; Bartelink H; Blitterswijk WJ van; Verheij M (2003). "Anti-cancer alkyl-lysophospholipids inhibit the phosphatidylinositol 3-kinase-Akt/PKB survival pathway". Anti-Cancer Drugs. 14 (2): 167–73. doi:10.1097/00001813-200302000-00011. PMID 12569304. S2CID 42468599.
^ Munder, PG; Modolell M; Andreesen R; Weltzien HU; Westphal O (1979). "Lysophosphatidylcholine ( Lysolecithin ) and its Synthetic Analogues. Immunemodulating and Other Biologic Effects". Springer Seminars in Immunopathology. 203 (2): 187–203. doi:10.1007/bf01891668. S2CID 42907729.
^ Lucas, A; Kim Y; Rivera-Pabon O; et al. (2010). "Targeting the PI3K/Akt cell survival pathway to induce cell death of HIV-1 infected macrophages with alkylphospholipid compounds". PLOS ONE. 5 (9): e13121. Bibcode:2010PLoSO...513121L. doi:10.1371/journal.pone.0013121. PMC 2948033. PMID 20927348.
^ Azzouz, S; Maache M; Garcia RG; Osuna A (2005). "activity of edelfosine, miltefosine and ilmofosine". Basic & Clinical Pharmacology & Toxicology. 96 (1): 60–5. doi:10.1111/j.1742-7843.2005.pto960109.x. PMID 15667597.
^ Klein-Franke, A; Munder PG (1992). "Alkyllysophospholipid prevents induction of experimental allergic encephalomyelitis". Journal of Autoimmunity. 5 (1): 83–91. doi:10.1016/s0896-8411(05)80053-8. PMID 1373062.
^ Noseda, A; Berens ME; White JG; Modest EJ (1988). "In vitro antiproliferative activity of combinations of ether lipid analogues and DNA-interactive agents against human tumor cells". Cancer Research. 48 (7): 1788–91. PMID 3349458.
^ Berdel, WE (1990). "Ether lipids and derivatives as investigational anticancer drugs. A brief review". Onkologie. 13 (4): 245–50. doi:10.1159/000216771. PMID 2234777.
^ Vogler, WR; Berdel WE (1993). "Autologous bone marrow transplantation with alkyl-lysophospholipid-purged marrow". Journal of Hematotherapy. 2 (1): 93–102. doi:10.1089/scd.1.1993.2.93. PMID 7921970.
^ Mollinedo, PG; Iglesia-Vicente J de la; Gajate C; et al. (2010). "Lipid raft-targeted therapy in multiple myeloma". Oncogene. 29 (26): 3748–3757. doi:10.1038/onc.2010.131. PMID 20418917.
^ Shafer, SH; Williams CL (2003). "Non-small and small cell lung carcinoma cell lines exhibit cell type-specific sensitivity to edelfosine-induced cell death and different cell line-specific responses to edelfosine treatment". International Journal of Oncology. 23 (2): 389–400. doi:10.3892/ijo.23.2.389. PMID 12851688.
^ Estella-Hermoso de Moendoza, A; Campanero M a; Iglesi-Vincente J de la; et al. (2009). "Antitumor alkyl ether lipid edelfosine: tissue distribution and pharmacokinetic behavior in healthy and tumor-bearing immunosuppressed mice". Clinical Cancer Research. 15 (3): 858–64. doi:10.1158/1078-0432.CCR-08-1654. PMID 19188156.
^ Arnold, B; Reuther R; Weltzien HU (1978). "Distribution and metabolism of synthetic alkyl analogs of lysophosphatidylcholine in mice". Biochimica et Biophysica Acta (BBA) - Lipids and Lipid Metabolism. 530 (1): 47–55. doi:10.1016/0005-2760(78)90125-x. PMID 687654.
^ ^a ^b "A Phase I/II trial of edelfosine purging of autologous bone marrow transplantation (ABMT) in acute leukemia (Meeting abstract)". 1996. Archived from the original on 2012-03-08. Retrieved 2011-02-28.
^ United States Patent 6514519. "Edelfosin for the treatment of brain tumors". Archived from the original on 14 December 2012. Retrieved 11 May 2011.{{cite web}}: CS1 maint: numeric names: authors list (link)
^ Drings, P; Günther I; Gatzmeier U; ulbrich F; et al. (1992). "Final Evaluation of a Phase II Study on the Effect of Edelfosine (an Ether Lipid) in Advanced Non-Small-Cell Bronchogenic Carcinoma". Onkologie. 15 (5): 375–382. doi:10.1159/000217391.
^ ^a ^b Houlihan, WJ; Lohmeyer M; Workman P; Cheon SH (1995). "Phospholipid antitumor agents". Medicinal Research Reviews. 15 (3): 157–223. doi:10.1002/med.2610150302. PMID 7658750. S2CID 6997551.
^ Munder, PG; Ferber E; Modolell M; Fischer H. (1969). "The influence of various adjuvants on the metabolism of phospholipids in macrophages". International Archives of Allergy and Applied Immunology. 36 (1): 117–28. doi:10.1159/000230731. PMID 4980286.