mifamurtide

mifamurtide

A fully synthetic lipophilic derivative of muramyl dipeptide, which is an immune stimulatory component of cell walls from Mycobacterium, used to manage high-grade, non-metastasising, resectable osteosarcoma after surgical excision in children to young adults (age 2 to 30).
 
Adverse effects
Fever (90%), tachycardia (50%), constipation (10%), vomiting, fatigue, infections, anaemia, anorexia, headache, diarrhoea.

Prognosis
Mifamurtide-treated patients have a 30% lower mortality than those treated with chemotherapy.
References in periodicals archive ?
Acquisition of specialty pharmaceutical mifamurtide (Mepact).
NICE added that data indicates that mifamurtide, when added to the usual treatment with surgery and chemotherapy, increases the number of patients who are effectively cured of their cancer.
The guidance includes additional recommendations supporting further research into the size of the effect of mifamurtide when combined with the type of chemotherapy typically used in UK clinical practice, as well as further collection of quality of life data from people who are cured.
Interferon alpha and Mifamurtide (liposomal muramyl tripeptide phosphatidyl ethanolamine; Mepact[R]) have been tried as adjuvants in treatment of osteosarcoma with encouraging results of improved DFS disease-free survival (DFS) of 7%.
The analysis of Mifamurtide was not only challenging, owing to the physical and chemical properties of the molecular entities themselves, but were compounded by the need for a transition from older methods to new ones that met current standards .
Mifamurtide, if made commercially available, will provide treating physicians with a new tool with significant potential to improve patient outcome and, most importantly, survival.
The evidence indicated that mifamurtide, when added to the usual treatment with surgery and chemotherapy, increases the number of patients who are effectively cured of their cancer.
Although the evidence presented to the NICE showed that mifamurtide plus multi-agent chemotherapy may be more effective than multi-agent chemotherapy alone, there was substantial uncertainty around how much extra benefit it could offer over and above currently available treatments, especially considering the exceptionally high cost the NHS is being asked to pay, NICE said.