Two common chemotherapeutic agents, Ifosfamide and cyclophosphamide, are isomers, bu only ifosfamide is known to cause nephrotoxicity and neurotoxicity. UPLC-ESI-QT0FMS-based metabolomics revealed five novel metabolites.
The results suggest that precursors of thiodiglycolic acid, may be responsible for Ifosfamide encephalopathy and nephropathy.