Dr. Grey AI

Motixafortide (Aphexda)

Peptide

Motixafortide is a 14-amino acid cyclic peptide CXCR4 inhibitor for hematopoietic stem cell mobilization. FDA-approved September 2023 in combination with G-CSF for autologous transplant in multiple myeloma. First new stem cell mobilization agent in 15 years. GENESIS Phase 3 trial (n=122): 67.5% achieved collection goal of 6x10^6 CD34+ cells/kg in 2 apheresis sessions vs 9.5% placebo (P<0.0001). High-affinity (Ki 0.32 nM) with sustained mobilization effect (>48 hours).

Quick Answer

What it is

Motixafortide is a 14-amino acid cyclic peptide CXCR4 inhibitor for hematopoietic stem cell mobilization. FDA-approved September 2023 in combination with G-CSF for autologous transplant in multiple myeloma.

Key findings

  • Grade A: Stem Cell Collection Target (Primary) (Multiple Myeloma)
  • Grade A: CD34+ Cell Yield (Multiple Myeloma)
  • Grade A: Safety and Tolerability (Multiple Myeloma)

Safety

No specific caution or interaction language was detected in the current summary/outcome notes.

⚠ī¸ Research Notice

This peptide information is for educational and research purposes only. Peptides may not be FDA-approved for human use and may only be legally available for research purposes. Consult qualified healthcare professionals before considering any peptide compounds.

ℹī¸ Quick Facts: Motixafortide (Aphexda)

Quick Facts: Motixafortide (Aphexda)

  • Best Evidence:Grade A
  • Conditions Studied:1
  • Research Outcomes:5
  • Grade A Findings:3
  • Grade B Findings:1
  • Key Effect:Multiple Myeloma
A3
B1
C1
D0
1 conditions ¡ 5 outcomes

Detailed Outcomes

A
Stem Cell Collection Target (Primary)
GENESIS Phase 3 (n=122): 67.5% motixafortide vs 9.5% placebo achieved >=6x10^6 CD34+ cells/kg in 2 apheresis sessions (P<0.0001). By local labs: 92.5% vs 21.4%. Led to FDA approval September 2023.
large↑Improves
A
CD34+ Cell Yield
GENESIS trial: Significantly higher total CD34+ cells mobilized vs placebo. More patients achieved target in first apheresis. Fewer total apheresis sessions required. First new mobilization agent in 15 years.
large↑Improves
A
Safety and Tolerability
GENESIS trial: Most common AEs (>20%) were injection site reactions, flushing, pruritus, back pain. Serious AEs in 5.4%. Manageable safety profile. No increased risks vs standard mobilization.
moderate↑Improves
B
Allogeneic Donor Mobilization
Allogeneic donor study: 92% (22/24) achieved >=2.0x10^6 CD34+ cells/kg in 2 leukapheresis. 100% (11/11) at 1.25 mg/kg dose. Single injection regimen offers convenience vs repeated plerixafor dosing.
large↑Improves
C
Anti-Cancer Activity
4 human trials support this finding. Human clinical trial data available.
small↑Improves

Research Citations (14)

Small molecule and peptide CXCR4 antagonists. A patent review from 2019 to 2024.
(2025)
PMID: 39925185
A comparative review of Aphexda and Mozobil for mobilization prior to stem cell collection.
(2024)
PMID: 38629183
Motixafortide and G-CSF to mobilize hematopoietic stem cells for autologous transplantation in multiple myeloma: a randomized phase 3 trial
(2023)
PMID: 37069359
Innovations in hematopoietic stem-cell mobilization: a review of the novel CXCR4 inhibitor motixafortide
(2023)
PMID: 37250913
Hematopoietic stem cell mobilization for allogeneic stem cell transplantation by motixafortide, a novel CXCR4 inhibitor
(2023)
PMID: 37598900
MSX-122: Is an effective small molecule CXCR4 antagonist in cancer therapy?
(2022)
PMID: 35623288
Hematopoietic stem cell mobilization: a concise review
(2021)
PMID: 32853612
Biased action of the CXCR4-targeting drug plerixafor is essential for its superior hematopoietic stem cell mobilization
(2021)
PMID: 33958763
At the Bedside: Profiling and treating patients with CXCR4-expressing cancers.
(2021)
PMID: 33089889
Motixafortide and Pembrolizumab Combined to Nanoliposomal Irinotecan, Fluorouracil, and Folinic Acid in Metastatic Pancreatic Cancer: The COMBAT/KEYNOTE-202 Trial.
(2021)
PMID: 34253578

Related Peptides

Carfilzomib (Kyprolis)

Peptide

1 shared condition ¡ 13 outcomes

Carfilzomib is a second-generation tetrapeptide epoxyketone proteasome inhibitor for multiple myeloma. FDA-approved 2012 (monotherapy), expanded 2015-2016 (combinations). ASPIRE Phase 3 (n=792): PFS 26.3 vs 17.6 months with KRd vs Rd (HR 0.69, P<0.001). OS improved to 48.3 vs 40.4 months. ENDEAVOR: PFS 18.7 vs 9.4 months vs bortezomib (HR 0.53). SAFETY: Significant cardiac toxicity - heart failure (4-16%), hypertension (9-27%), thromboembolism (24%). Requires cardiac monitoring.

Bortezomib

Peptide

1 shared condition ¡ 14 outcomes

Bortezomib is the first-in-class proteasome inhibitor for multiple myeloma and mantle cell lymphoma. FDA-approved 2003 (relapsed MM), 2008 (frontline), 2014 (MCL). A-GRADE evidence: APEX Phase 3 (n=669) showed 38% vs 18% response rate vs dexamethasone (P<0.001), 80% vs 66% 1-year survival. VISTA (n=682): VMP superior to MP in transplant-ineligible elderly. SAFETY CONCERN: Peripheral neuropathy 31-45% (dose-limiting), thrombocytopenia 26-30%. Subcutaneous route reduces neuropathy vs IV. Neuropathy 75-81% reversible with dose modification. PRESCRIPTION ONLY - oncology setting.