Amifostine (WR-2721, ethiofos) is a phosphorylated sulfhydryl-containing prodrug that protects tissues from the cytotoxic actions of radiation and chemotherapy. It was originally developed by the military for use as a radioprotectant in the event of nuclear warfare. Amifostine has selective cytoprotective effects for normal tissues. In studies with cisplatin, amifostine is
effective in preventing acute and cumulative nephrotoxicity and protects against dose-related neurotoxicity. In the pivotal US
trial, amifostine reduced the incidence and severity of myelosuppression, nephrotoxicity and peripheral neuropathies seen with
cisplatin and cyclophosphamide combination therapy.