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Last Updated: December 12, 2025

CLINICAL TRIALS PROFILE FOR CYCLOPHOSPHAMIDE


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505(b)(2) Clinical Trials for CYCLOPHOSPHAMIDE

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Dosage NCT01760226 ↗ Dose Adjusted EPOCH-R, to Treat Mature B Cell Malignancies Completed National Cancer Institute (NCI) Early Phase 1 2013-01-01 The subject is invited to take part in this research study because s/he has been diagnosed with Diffuse Large B-Cell Lymphoma (DLBCL), Primary Mediastinal B-cell Lymphoma (PMBCL), or Post-transplant Lymphoproliferative Disorder (PTLD). In an attempt to improve cure rates while reducing harmful effects from drugs, oncologists are developing new treatment protocols. One such protocol, entitled dose-adjusted EPOCH-R, utilizes two major new strategies. First, the treatment approach utilizes continuous infusion of chemotherapy over four days, instead of being administered over minutes or hours. Secondly, the doses of some medications involved are increased or decreased based on how the drugs affect the subject's ability to produce blood cells, which is used as a measure of how rapidly the body is processing drugs. Using this approach in adults, researchers have shown improved cure rates in these cancers. Additionally, the harmful effects experienced by patients has been mild, with mucositis, severe infections, and tumor lysis syndrome occurring rarely. However, this new dosing method has never been used in children, and the effectiveness and side effects of this new method are unknown in children. The purpose of this study is to look at the safety of dose-adjusted EPOCH-R in the treatment of children with mature B-cell cancers, and to see if we can maintain cure rates (as has been shown in adults). This study represents the first trial of dose-adjusted EPOCH-R in children.
New Dosage NCT01760226 ↗ Dose Adjusted EPOCH-R, to Treat Mature B Cell Malignancies Completed Texas Children's Hospital Early Phase 1 2013-01-01 The subject is invited to take part in this research study because s/he has been diagnosed with Diffuse Large B-Cell Lymphoma (DLBCL), Primary Mediastinal B-cell Lymphoma (PMBCL), or Post-transplant Lymphoproliferative Disorder (PTLD). In an attempt to improve cure rates while reducing harmful effects from drugs, oncologists are developing new treatment protocols. One such protocol, entitled dose-adjusted EPOCH-R, utilizes two major new strategies. First, the treatment approach utilizes continuous infusion of chemotherapy over four days, instead of being administered over minutes or hours. Secondly, the doses of some medications involved are increased or decreased based on how the drugs affect the subject's ability to produce blood cells, which is used as a measure of how rapidly the body is processing drugs. Using this approach in adults, researchers have shown improved cure rates in these cancers. Additionally, the harmful effects experienced by patients has been mild, with mucositis, severe infections, and tumor lysis syndrome occurring rarely. However, this new dosing method has never been used in children, and the effectiveness and side effects of this new method are unknown in children. The purpose of this study is to look at the safety of dose-adjusted EPOCH-R in the treatment of children with mature B-cell cancers, and to see if we can maintain cure rates (as has been shown in adults). This study represents the first trial of dose-adjusted EPOCH-R in children.
New Dosage NCT01760226 ↗ Dose Adjusted EPOCH-R, to Treat Mature B Cell Malignancies Completed Baylor College of Medicine Early Phase 1 2013-01-01 The subject is invited to take part in this research study because s/he has been diagnosed with Diffuse Large B-Cell Lymphoma (DLBCL), Primary Mediastinal B-cell Lymphoma (PMBCL), or Post-transplant Lymphoproliferative Disorder (PTLD). In an attempt to improve cure rates while reducing harmful effects from drugs, oncologists are developing new treatment protocols. One such protocol, entitled dose-adjusted EPOCH-R, utilizes two major new strategies. First, the treatment approach utilizes continuous infusion of chemotherapy over four days, instead of being administered over minutes or hours. Secondly, the doses of some medications involved are increased or decreased based on how the drugs affect the subject's ability to produce blood cells, which is used as a measure of how rapidly the body is processing drugs. Using this approach in adults, researchers have shown improved cure rates in these cancers. Additionally, the harmful effects experienced by patients has been mild, with mucositis, severe infections, and tumor lysis syndrome occurring rarely. However, this new dosing method has never been used in children, and the effectiveness and side effects of this new method are unknown in children. The purpose of this study is to look at the safety of dose-adjusted EPOCH-R in the treatment of children with mature B-cell cancers, and to see if we can maintain cure rates (as has been shown in adults). This study represents the first trial of dose-adjusted EPOCH-R in children.
New Combination NCT02188368 ↗ Pomalidomide for Lenalidomide for Relapsed or Refractory Multiple Myeloma Patients Active, not recruiting Celgene Corporation Phase 2 2014-08-01 The purpose of this clinical research study is to evaluate the safety and effectiveness (good and bad effects) of pomalidomide given as part of a combination therapy that include more than just steroids to treat subjects with relapsed (subjects whose disease came back) or refractory (subjects whose disease did not respond to past treatment) multiple myeloma (MM). Pomalidomide (alone or in combination with dexamethasone) has been approved by the United States Food and Drug Administration (FDA) for the treatment of MM patients who have received at least two prior therapies, including lenalidomide and bortezomib, and have demonstrated disease progression on or within 60 days of completion of their last therapy. However, the use of pomalidomide in combination with other drugs used to treat MM, such as chemotherapeutic agents and proteasome inhibitors, is currently being tested and is not approved. Pomalidomide is in the same drug class as thalidomide and lenalidomide. Like lenalidomide, pomalidomide is a drug that alters the immune system and it may also interfere with the development of small blood vessels that help support tumor growth. Therefore, in theory, it may reduce or prevent the growth of cancer cells. The testing done with pomalidomide thus far has shown that it is well-tolerated and effective for subjects with MM both on its own and in combination with dexamethasone. Using another drug class, namely proteasome inhibitors, we have demonstrated that simply replacing a proteasome inhibitor with another in an established anti-myeloma treatment regimen can frequently overcome resistance regardless of the other agents that are part of the anti-myeloma regimen. Importantly, the toxicity profile of the new combinations closely resembled that of the proteasome inhibitor administered as a single agent. Based on this experience, we hypothesize that the replacement of lenalidomide with pomalidomide will yield similar results in a similar relapsed/refractory MM patient population.
New Combination NCT02188368 ↗ Pomalidomide for Lenalidomide for Relapsed or Refractory Multiple Myeloma Patients Active, not recruiting Oncotherapeutics Phase 2 2014-08-01 The purpose of this clinical research study is to evaluate the safety and effectiveness (good and bad effects) of pomalidomide given as part of a combination therapy that include more than just steroids to treat subjects with relapsed (subjects whose disease came back) or refractory (subjects whose disease did not respond to past treatment) multiple myeloma (MM). Pomalidomide (alone or in combination with dexamethasone) has been approved by the United States Food and Drug Administration (FDA) for the treatment of MM patients who have received at least two prior therapies, including lenalidomide and bortezomib, and have demonstrated disease progression on or within 60 days of completion of their last therapy. However, the use of pomalidomide in combination with other drugs used to treat MM, such as chemotherapeutic agents and proteasome inhibitors, is currently being tested and is not approved. Pomalidomide is in the same drug class as thalidomide and lenalidomide. Like lenalidomide, pomalidomide is a drug that alters the immune system and it may also interfere with the development of small blood vessels that help support tumor growth. Therefore, in theory, it may reduce or prevent the growth of cancer cells. The testing done with pomalidomide thus far has shown that it is well-tolerated and effective for subjects with MM both on its own and in combination with dexamethasone. Using another drug class, namely proteasome inhibitors, we have demonstrated that simply replacing a proteasome inhibitor with another in an established anti-myeloma treatment regimen can frequently overcome resistance regardless of the other agents that are part of the anti-myeloma regimen. Importantly, the toxicity profile of the new combinations closely resembled that of the proteasome inhibitor administered as a single agent. Based on this experience, we hypothesize that the replacement of lenalidomide with pomalidomide will yield similar results in a similar relapsed/refractory MM patient population.
New Combination NCT02436707 ↗ Novel Combination Therapy in the Treatment of Relapsed and Refractory Aggressive B-Cell Lymphoma Recruiting Janssen, LP Phase 2 2015-05-05 The purpose of this study is to find out what effects new combinations of treatment will have this disease. New promising treatment strategies will be added to this study as they are available to be compared against the standard treatment.
New Combination NCT02436707 ↗ Novel Combination Therapy in the Treatment of Relapsed and Refractory Aggressive B-Cell Lymphoma Recruiting Karyopharm Therapeutics Inc Phase 2 2015-05-05 The purpose of this study is to find out what effects new combinations of treatment will have this disease. New promising treatment strategies will be added to this study as they are available to be compared against the standard treatment.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for CYCLOPHOSPHAMIDE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000361 ↗ Autoimmunity in Inner Ear Disease Terminated National Institute on Deafness and Other Communication Disorders (NIDCD) Phase 3 1998-03-01 The purpose of this study is to determine whether prednisone, methotrexate, and cyclophosphamide are effective in the treatment of rapidly progressive sensorineural hearing loss in both ears. This condition is called autoimmune inner ear disease (AIED), because it is thought that the hearing loss is triggered by an autoimmune process. Treatment attempts to suppress or control this process with powerful anti-inflammatory drugs. This is a Phase III, outpatient study. All study participants will be assigned to one of four different groups testing the experimental use of drugs. The study is scheduled to run for 18 months, with a minimum of 11 visits per participant.
NCT00000420 ↗ Safety of Estrogens in Lupus: Birth Control Pills Completed National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Phase 3 1997-06-01 Safety of Estrogens in Lupus Erythematosus - National Assessment (SELENA) is a study to test whether women with systemic lupus erythematosus (SLE or lupus) can safely use estrogen. We will determine this by looking at the effects of oral contraceptives (birth control pills, also known as "the pill") on disease activity and severity in women with SLE. The results of the study will show whether it is safe for women with SLE to use the pill.
NCT00000420 ↗ Safety of Estrogens in Lupus: Birth Control Pills Completed Office of Research on Women's Health (ORWH) Phase 3 1997-06-01 Safety of Estrogens in Lupus Erythematosus - National Assessment (SELENA) is a study to test whether women with systemic lupus erythematosus (SLE or lupus) can safely use estrogen. We will determine this by looking at the effects of oral contraceptives (birth control pills, also known as "the pill") on disease activity and severity in women with SLE. The results of the study will show whether it is safe for women with SLE to use the pill.
NCT00000420 ↗ Safety of Estrogens in Lupus: Birth Control Pills Completed New York University School of Medicine Phase 3 1997-06-01 Safety of Estrogens in Lupus Erythematosus - National Assessment (SELENA) is a study to test whether women with systemic lupus erythematosus (SLE or lupus) can safely use estrogen. We will determine this by looking at the effects of oral contraceptives (birth control pills, also known as "the pill") on disease activity and severity in women with SLE. The results of the study will show whether it is safe for women with SLE to use the pill.
NCT00000420 ↗ Safety of Estrogens in Lupus: Birth Control Pills Completed NYU Langone Health Phase 3 1997-06-01 Safety of Estrogens in Lupus Erythematosus - National Assessment (SELENA) is a study to test whether women with systemic lupus erythematosus (SLE or lupus) can safely use estrogen. We will determine this by looking at the effects of oral contraceptives (birth control pills, also known as "the pill") on disease activity and severity in women with SLE. The results of the study will show whether it is safe for women with SLE to use the pill.
NCT00000596 ↗ Diffuse Fibrotic Lung Disease Completed National Heart, Lung, and Blood Institute (NHLBI) Phase 2 1978-06-01 To determine the effects of cyclophosphamide compared with prednisone, dapsone, or high-dose intermittent 'pulse' therapy with methylprednisolone in patients with idiopathic pulmonary fibrosis. Also, to evaluate the use of intermittent, short-term, high-dose intravenous corticosteroids in patients with sarcoidosis. There were actually four separate clinical trials.
NCT00000658 ↗ A Phase III Randomized Trial of Low-Dose Versus Standard-Dose mBACOD Chemotherapy With rGM-CSF for Treatment of AIDS-Associated Non-Hodgkin's Lymphoma Completed Schering-Plough Phase 3 1969-12-31 To determine the impact of dose intensity on tumor response and survival in patients with HIV-associated non-Hodgkin's lymphoma (NHL). HIV-infected patients are at increased risk for developing intermediate and high-grade NHL. While combination chemotherapy for aggressive B-cell NHL in the absence of immunodeficiency is highly effective, the outcome of therapy for patients with AIDS-associated NHL has been disappointing. Treatment is frequently complicated by the occurrence of multiple opportunistic infections, as well as the presence of poor bone marrow reserve, making the administration of standard doses of chemotherapy difficult. A recent study was completed using a low-dose modification of the standard mBACOD (cyclophosphamide, doxorubicin, vincristine, bleomycin, dexamethasone, methotrexate ) treatment. A 46 percent response rate was observed in patients treated with this combination of chemotherapeutic agents, with a number of durable remissions and reduced toxicity when compared to previous experience with more standard treatments. A subsequent study showed similar effectiveness using a lower dose of methotrexate administered on day 15. It is hoped that the use of sargramostim (granulocyte-macrophage colony-stimulating factor; GM-CSF) will improve bone marrow function and allow for administration of a higher dose of chemotherapy.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for CYCLOPHOSPHAMIDE

Condition Name

Condition Name for CYCLOPHOSPHAMIDE
Intervention Trials
Breast Cancer 502
Lymphoma 388
Leukemia 311
Multiple Myeloma 209
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Condition MeSH

Condition MeSH for CYCLOPHOSPHAMIDE
Intervention Trials
Lymphoma 1004
Leukemia 752
Breast Neoplasms 738
Leukemia, Lymphoid 484
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Clinical Trial Locations for CYCLOPHOSPHAMIDE

Trials by Country

Trials by Country for CYCLOPHOSPHAMIDE
Location Trials
China 963
Italy 601
Australia 570
Spain 520
France 452
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Trials by US State

Trials by US State for CYCLOPHOSPHAMIDE
Location Trials
Texas 708
California 703
New York 657
Maryland 579
Ohio 460
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Clinical Trial Progress for CYCLOPHOSPHAMIDE

Clinical Trial Phase

Clinical Trial Phase for CYCLOPHOSPHAMIDE
Clinical Trial Phase Trials
PHASE4 4
PHASE3 30
PHASE2 166
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Clinical Trial Status

Clinical Trial Status for CYCLOPHOSPHAMIDE
Clinical Trial Phase Trials
Completed 1587
RECRUITING 993
Active, not recruiting 385
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Clinical Trial Sponsors for CYCLOPHOSPHAMIDE

Sponsor Name

Sponsor Name for CYCLOPHOSPHAMIDE
Sponsor Trials
National Cancer Institute (NCI) 997
M.D. Anderson Cancer Center 191
Children's Oncology Group 101
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Sponsor Type

Sponsor Type for CYCLOPHOSPHAMIDE
Sponsor Trials
Other 5297
Industry 1639
NIH 1158
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Clinical Trials Update, Market Analysis, and Projection for Cyclophosphamide

Last updated: October 28, 2025


Introduction

Cyclophosphamide, a chemotherapeutic and immunosuppressive agent, has been a cornerstone in the treatment of various cancers and autoimmune disorders for decades. Originally developed in the 1950s, its utility persists due to its proven efficacy and versatility. As the landscape of oncology evolves with novel therapies, understanding current clinical development, market dynamics, and forecasted trends for Cyclophosphamide is critical for stakeholders—pharmaceutical companies, investors, and healthcare providers alike.


Clinical Trials Landscape

Current Clinical Trials and Indications

Cyclophosphamide remains an active subject in clinical research, especially in combination regimens and novel delivery systems. Data from ClinicalTrials.gov indicates over 50 ongoing or recruiting trials as of 2023, spanning indications including:

  • Cancer Treatment: Predominantly non-Hodgkin lymphoma, breast cancer, ovarian cancer, multiple myeloma, and leukemia. Trials focus on optimizing dosing, reducing toxicity, and combining with targeted therapies and immune checkpoint inhibitors.
  • Autoimmune Disorders: Investigations into its use for severe systemic lupus erythematosus and vasculitis continue, emphasizing long-term safety and efficacy.
  • Innovative Formulations: Several trials explore liposomal formulations and conjugates aimed at enhancing bioavailability and minimizing adverse effects.

Emerging Trends and Innovations

Recent research emphasizes dose reduction strategies and targeted delivery systems. Liposomal cyclophosphamide, for example, aims to improve tumor targeting, reduce systemic toxicity, and overcome resistance. Furthermore, trials integrating cyclophosphamide with immune checkpoint inhibitors reflect a shift toward combination therapies harnessing immunomodulatory effects.

Regulatory Status

Aside from its established generic status, cyclophosphamide has seen accelerated approvals for specific indications, especially where combination regimens demonstrate superior efficacy. Notably, ongoing phase III trials evaluating its role in CAR-T cell therapy conditioning highlight its evolving therapeutic landscape.


Market Analysis

Market Size and Historical Trends

The global cyclophosphamide market was valued at approximately $1.2 billion in 2022, with consistent growth driven by expanding oncology indications and generics proliferation. Its legacy status ensures widespread use in both developed markets and emerging economies.

Market Drivers

  • Rising Incidence of Cancer: The increasing prevalence of cancers, especially breast, lung, and hematological malignancies, sustains demand. The WHO estimates annual global cancer cases exceeding 19 million, fueling chemotherapeutic needs.
  • Expanding Autoimmune Disease Treatments: Autoimmune indications contribute to steady demand, particularly in institutions prioritizing established, cost-effective therapies.
  • Generics and Cost Efficiency: High patent expiration rates (~2000s) led to entry of generic versions, lowering manufacturing costs and increasing accessibility.

Market Challenges

  • Toxicity and Side Effects: Cyclophosphamide’s known adverse effects, including hemorrhagic cystitis, myelosuppression, and secondary malignancies, limit its use, especially with newer, targeted agents offering improved safety profiles.
  • Emergence of Novel Therapeutics: Drugs like lenalidomide, rituximab, and immune checkpoint inhibitors increasingly supplant cyclophosphamide in certain indications, impacting market share.
  • Regulatory and Patent Constraints: Most formulations are off-patent, creating pricing pressures, although proprietary formulations or delivery systems present opportunities for differentiation.

Regional Market Dynamics

  • North America: Dominates with a market share exceeding 40%, driven by advanced oncology centers and clinical research activity.
  • Europe: The second-largest market, with stable demand, though cost containment efforts influence prescribing patterns.
  • Asia-Pacific: Expected to exhibit the highest growth (CAGR ~6-8%), fueled by increasing healthcare access, cancer burden, and local manufacturing capabilities.

Competitive Landscape

The market comprises numerous generic manufacturers and a few branded or specialized formulations. Companies like Teva, Sandoz, and Baxter dominate the generics space. Innovator companies focusing on novel delivery formats or combination regimens seek to carve niche segments.


Future Market Projections

Based on current data, the cyclophosphamide market is projected to grow at a compounded annual growth rate (CAGR) of approximately 4-6% through 2030.

Factors Supporting Growth

  • Continued expansion of indications, including investigational uses in autoimmune and hematologic disorders.
  • Development of targeted formulations minimizing toxicity, extending patient suitability.
  • Integration into combination therapies, especially in immuno-oncology.
  • Growing healthcare infrastructure in emerging economies expanding access.

Potential Market Disruptors

  • Advancement of targeted therapies and immunotherapies could reduce reliance on cytotoxic agents like cyclophosphamide.
  • Regulatory shifts towards defining safer alternatives for high-toxicity chemotherapies.
  • Patient-centric drug delivery innovations may alter administration practices; for example, oral or outpatient formulations could gain prominence.

Conclusion

Cyclophosphamide remains a vital chemotherapeutic agent with a stable global market, fueled by its proven efficacy and evolving therapeutic applications. Clinical trials continue to refine its use, especially in combination regimens and novel delivery systems that aim to mitigate toxicity and enhance outcomes. Market prospects are cautiously optimistic, with moderate growth anticipated over the coming decade, primarily driven by expanding indications and regional healthcare development.


Key Takeaways

  • Clinical Trials: Ongoing studies focus on optimizing dosing, reducing toxicity, and integrating cyclophosphamide into immuno-oncology strategies. Innovative formulations like liposomal versions are promising avenues.
  • Market Dynamics: The global cyclophosphamide market benefits from high cancer prevalence, autoimmunity treatments, and affordability due to generics, maintaining steady demand despite competition from newer therapies.
  • Growth Outlook: A compounded growth rate of 4-6% is expected till 2030, supported by emerging indications, combination therapies, and regional market expansion, particularly in Asia-Pacific.
  • Challenges: Toxicity concerns and competition from targeted agents pose long-term threats to market share, prompting ongoing research into safer formulations.
  • Strategic Opportunity: Firms investing in novel formulations and combination strategies can capitalize on the drug’s established clinical utility while addressing safety and efficacy limitations.

FAQs

  1. What are the main therapeutic indications for cyclophosphamide today?

    • Primarily used in hematologic cancers such as non-Hodgkin lymphoma, leukemia, and multiple myeloma; also indicated in certain solid tumors like breast and ovarian cancers, as well as autoimmune diseases like lupus.
  2. Are there any recent regulatory updates regarding cyclophosphamide?

    • While most formulations are off-patent, ongoing trials exploring combination regimens and novel formulations may lead to expanded or modified indications, supported by FDA and EMA regulatory pathways.
  3. What are the primary challenges facing the future use of cyclophosphamide?

    • Toxicity risks, especially hemorrhagic cystitis, secondary malignancies, and myelosuppression; competition from newer targeted therapies with improved safety profiles.
  4. How is innovation impacting cyclophosphamide's market?

    • The development of liposomal and conjugated formulations aims to reduce toxicity and improve targeting, potentially expanding its use and prolonging market relevance.
  5. What regional differences influence cyclophosphamide’s market growth?

    • Developed markets lead in use due to advanced healthcare infrastructure, but rapid growth in Asia-Pacific driven by rising cancer incidence and expanding healthcare access is notable.

References

  1. [1] ClinicalTrials.gov. (Accessed 2023).
  2. [2] Market Research Future. (2022). Global Oncology Drugs Market.
  3. [3] WHO Cancer Burden Data. (2021).
  4. [4] FDA. (2023). Drug approvals and regulatory updates on oncology agents.
  5. [5] GlobalData. (2023). Oncology therapeutics market analysis.

This analysis provides a comprehensive overview for industry stakeholders seeking strategic insights into cyclophosphamide’s clinical and market outlook.

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