A synthetic lipophilic derivative of muramyl dipeptide, an immune stimulatory component of mycobacterial cell walls. It is approved in Europe to manage high-grade, non-metastasising, resectable osteosarcoma after surgical excision in patients 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 alone.
Mechanism This agent simulates a bacterial infection by binding to NOD2, a so-called pattern recognition receptor, activating white cells, triggering increased production of TNF-α, IL1, IL6, IL8, IL12, and other cytokines, as well as ICAM-1. The activated white cells attack cancer cells
Synonyms Liposomal muramyl tripeptide phosphatidyl ethanolamine, Mepact®