Which alkylating agent is primarily activated by CYP 2B6 enzymes?

Cyclophosphamide is an alkylating agent that primarily requires activation by the cytochrome P450 enzyme system, particularly the CYP 2B6 enzymes. This drug is administered as a prodrug and needs to be converted into its active forms, including hydroxycyclophosphamide and aldophosphamide, through metabolic processes involving CYP enzymes. The relevance of CYP 2B6 in its metabolism highlights the importance of genetic variations in this enzyme, which can significantly impact the drug's efficacy and toxicity profile in different patients.

In oncology, cyclophosphamide is commonly used in various chemotherapy regimens due to its effectiveness against a wide range of cancers. Understanding the metabolism of cyclophosphamide via CYP 2B6 can aid clinicians in predicting patient responses and tailoring chemotherapy protocols accordingly.