CYTOPROTECTION IN CHEMOTHERAPY AND RADIOTHERAPY WITH AMIFOSTINE (ETHYOL) - A NEW STRATEGY IN ONCOLOGY

Amifostine (WR-2721, Ethyol), a phosphorylated aminothiol, was origina lly developed as a radioprotective agent. Since numerous preclinical s tudies showed that, following dephosphorylation to the active thiol WR -1065, amifostine selectively protected normal tissues from the damagi ng effects of irradiation and of several cytotoxic agents without redu cing the antitumor activity, an intensive clinical development in chem o- and radiotherapy studies was performed. In clinical trials, amifost ine proved to be an effective cytoprotector in patients receiving trea tment with antineoplastic agents or irradiation. It significantly redu ced the incidence and severity of acute, cumulative and delayed toxici ties associated with antineoplastic therapy, allowing better patient t olerance of current regimens and possible dose escalation. This protec tion is achieved without any reduction in the antitumor efficacy. Thus , the integration of amifostine into oncological regimens represents a new 'preventive' strategy for a more tolerable and selective therapy.