mifamurtide + chemotherapy

**mifamurtide + chemotherapy** is a combination treatment used primarily for **high-grade, non-metastatic, resectable osteosarcoma** in children, adolescents, and young adults up to age 30. The regimen involves the immunomodulator mifamurtide (a fully synthetic derivative of muramyl dipeptide, related to bacterial cell wall components) in combination with multi-agent cytotoxic chemotherapy (typically drugs such as doxorubicin, cisplatin, high-dose methotrexate, and ifosfamide). Mifamurtide acts by binding to the NOD2 pattern recognition receptor on monocytes and macrophages, simulating bacterial infection and activating an immune response. This activation leads to the release of proinflammatory cytokines (such as TNF-α, interleukin 1, interleukin 6, interleukin 8, interleukin 12, ICAM-1), promoting the immune system’s direct antitumor effects. Clinical trials show the addition of mifamurtide to chemotherapy improves overall survival in osteosarcoma, with approval for this regimen in Europe and other countries.

Other names

liposomal muramyl tripeptide phosphatidylethanolamineL-MTP-PE