NCIt definition : A peptide-drug conjugate composed of a peptide conjugated, via an aminopeptidase-targeting
linkage, to the alkylating agent melphalan, with potential antineoplastic and anti-angiogenic
activities. Upon administration, the highly lipophilic melphalan flufenamide penetrates
cell membranes and enters cells. In aminopeptidase-positive tumor cells, melphalan
flufenamide is hydrolyzed by peptidases to release the hydrophilic alkylating agent
melphalan. This results in the specific release and accumulation of melphalan in aminopeptidase-positive
tumor cells. Melphalan alkylates DNA at the N7 position of guanine residues and induces
DNA intra- and inter-strand cross-linkages. This results in the inhibition of DNA
and RNA synthesis and the induction of apoptosis, thereby inhibiting tumor cell proliferation.
Peptidases are overexpressed by certain cancer cells. The administration of melphalan
flufenamide allows for enhanced efficacy and reduced toxicity compared to melphalan.;