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Evofosfamide is a hypoxia‑activated prodrug of the cytotoxin bromo-isophosphoramide mustard (Br-IPM), conjugated with a 2-nitroimidazole moiety. It is designed to selectively target and kill hypoxic cells within solid tumors, which are often resistant to standard therapies. Under low oxygen conditions typical of many tumor microenvironments, evofosfamide undergoes bioreductive activation by cellular reductases, releasing Br-IPM—a DNA alkylating agent that induces DNA crosslinks and leads to cell death. Evofosfamide has been investigated for multiple cancer types including pancreatic cancer, soft tissue sarcoma, multiple myeloma, and other advanced solid tumors—often in combination with other agents such as doxorubicin or gemcitabine[1][3][6]. The drug was developed by Threshold Pharmaceuticals in partnership with Merck[6][9].
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