Plerixafor
| Evidence Level: L5 | Predicted Indications: 6 |
Table of Contents
Plerixafor: CMM7
One-Sentence Summary
Plerixafor is a CXCR4 antagonist, best known as a hematopoietic stem cell mobiliser used with autologous transplantation in multiple myeloma and non-Hodgkin lymphoma. Currently there are 0 clinical trials and 0 publications for this specific subtype, so the prediction rests on the model score alone.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | CMM7 |
| TxGNN Prediction Score | 0.9934 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (5 of 5) – CDSCO approval status is not included in this data |
| Number of Listed Products | 5 (valid: 5) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Plerixafor blocks the CXCR4 receptor and disrupts the CXCR4/CXCL12 axis. This axis helps myeloma cells home to and stay in the bone marrow, where the protective niche supports their survival. The drug also binds ACKR3, a related chemokine receptor.
Plasma cell myeloma and its indolent form are closely related diseases, so a link through this bone marrow retention mechanism is plausible. Plerixafor is already used in myeloma patients to mobilise stem cells, but that is a supportive-care use, not treatment of the myeloma itself.
The high TxGNN score is probably inflated by the similarity between the new indication and the original one. No trials or publications specific to the indolent subtype were found, so the mechanistic argument has not been tested clinically.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
India Market Information
| Authorization Number | Product Name | Dosage Form | Manufacturer |
|---|---|---|---|
| 43308 | Celstemx 24mg Injection | Vial of 1.2 ml injection | Sayre Therapeutics Pvt Ltd |
| 136994 | Mozifor Injection | Vial of 1.2 ml injection | Hetero Drugs Ltd |
| 43149 | Celrixafor Injection | Vial of 1 injection | Celon Laboratories Ltd |
| 142724 | Mostim Injection | Vial of 1.2 ml injection | Zydus Cadila |
| 203215 | Stemfor Injection | Vial of 1.2 ml injection | Intas Pharmaceuticals Ltd |
All five registrations are valid single-ingredient injectable products.
Safety Considerations
- Disease-level cautions flagged in the knowledge graph (not taken from product labelling): thrombocytopenia, impaired renal function, and leukaemia.
Please refer to the package insert for full warnings, contraindications and drug interaction information.
Conclusion and Next Steps
Decision: Hold
Rationale: Plerixafor’s current myeloma use is supportive (stem cell mobilisation), not disease-modifying, and the high score is likely inflated by similarity to the original indication.
Among the other TxGNN predictions for this drug, myeloid leukaemia has much stronger support. It has 25 registered trials (Phase 1 to Phase 2, several completed with 39 to 52 patients) of plerixafor as a chemosensitiser alongside cytarabine-based regimens, and 20 publications. These include a systematic review and Phase 1/2 studies. No Phase 3 or randomised efficacy data exist yet, so that indication reaches only evidence level L2 and is a research question, not a go decision.
To proceed, the following is needed:
- Clinical or preclinical data specific to indolent plasma cell myeloma, including disease-modifying (not stem cell mobilisation) endpoints
- Package insert warnings and contraindications from the Indian product labels
- Confirmation of the mechanism of action from a curated drug database
- A review of whether the indolent-myeloma population could tolerate repeated dosing, given the cautions listed above
- For the myeloid leukaemia direction, a randomised evaluation before any recommendation
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.