Motixafortide — Drug Monograph

Brand names: Aphexda

Drug class: Supportive Care Agent

Mechanism of Action

CXCR4 antagonist. The CXCR4 receptor and its ligand CXCL12 (SDF-1) anchor hematopoietic stem cells within the bone marrow niche. By blocking this axis, motixafortide releases stem cells into the peripheral blood, increasing the yield of CD34+ cells available for apheresis collection and subsequent autologous transplantation.

FDA Indications

• In combination with filgrastim (G-CSF) to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in patients with multiple myeloma (FDA approved 2023)

Common Side Effects

• Injection-site reactions (pain, erythema, pruritus)
• Pruritus
• Flushing
• Back pain

Clinical Pearl

Motixafortide (GENESIS) added to G-CSF sharply increases the proportion of myeloma patients who reach their CD34+ collection target in a single apheresis, reducing the number of collection days. Premedicate for histamine-mediated reactions and give it in the evening to time collection the next morning.

Related Therapies & Mechanisms

• Plerixafor (Mozobil) — Supportive Care Agent · Supportive Care
• Avatrombopag (Doptelet) — Supportive Care Agent · Supportive Care
• Defibrotide (Defitelio) — Supportive Care Agent · Supportive Care
• Dexrazoxane (Zinecard) — Supportive Care Agent · Supportive Care