WO2022038490A1

WO2022038490A1 - Stable formulations comprising thiotepa

Info

Publication number: WO2022038490A1
Application number: PCT/IB2021/057527
Authority: WO
Inventors: Sharon CUNNINGHAM; Orlaith RYAN; Johannes Jan Platteeuw
Original assignee: Shorla Pharma Ltd
Priority date: 2020-08-17
Filing date: 2021-08-16
Publication date: 2022-02-24

Abstract

The present disclosure provides pharmaceutical compositions comprising thiotepa, water, one selected from PEG, such as PEG400 or PEG600, and DMSO, and optionally thiosulfate. Also provided is a method for treating cancer in a subject, or myeloablation prior to bone marrow transplantation using the composition. A method for enhancing the stability of a thiotepa formulation is also contemplated.

Description

STABLE FORMULATIONS COMPRISING THIOTEPA

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to U.S. Patent Application No. 63/066,378, filed on August 17, 2020. The entire disclosure of the application identified in this paragraph is incorporated herein by reference.

FIELD

[0002] The present disclosure relates to compositions comprising thiotepa and methods for using the same for treating a disease in a subject.

BACKGROUND

[0003] Thiotepa is a nitrogen mustard alkylating agent with antitumor properties. It is indicated for treating adenocarcinoma of the breast, superficial papillary carcinoma of the urinary bladder, and adult and pediatric hematological diseases (e.g. Hodgkin’s disease or leukemia). Thiotepa is also indicated for controlling intracavitary effusions secondary to diffuse or localized neoplastic disease of serosal cavities. Thiotepa is also used as a conditioning treatment prior to allogeneic or autologous hematopoietic progenitor cell transplantation or for use in palliation of neoplastic diseases.

[0004] Thiotepa is generally unstable in aqueous solutions, which leads to the generation of impurities and/or thiotepa degradation products following storage. The aqueous instability renders ready-to-use liquid dosage forms of thiotepa difficult to store. [0005] It is typically available as a freeze-dried product (15 mg to 100 mg) without excipients to be reconstituted to a concentration of 10 mg/mL in sterile water for injection. When provided intravenously, thiotepa can be provided as a 2-4 hour infusion at doses ranging from 3.24-14 mg/kg/day for a cumulative dose of 1050 mg/m² (42mg/kg) to treat solid tumors.

[0006] US 2014/0005148 describes non-aqueous formulations of nitrogen mustards, including thiotepa. Nitrogen mustards are susceptible to nucleophilic attack by water and other aqueous solvents, such as ethanol, thereby degrading the nitrogen mustard into degradation products.

[0007] EP 0 419 890 reports lyophilized and water-free thiotepa compositions comprising polyethylene glycol (PEG). This reference reports that thiotepa reconstituted in water should be used within five days because reconstituted thiotepa stored longer than five days show a substantial loss of potency.

SUMMARY

[0008] This section provides a general summary of disclosure, and is not a comprehensive disclosure of its full scope or all of its features.

[0009] The present disclosure relates to compositions comprising thiotepa, PEG or DMSO, and water. The disclosed compositions are stable and may be suitable for injection. In an embodiment, the thiotepa formulation can be administered for the treatment of a disease, particularly, cancer, or myeloablation prior to bone marrow transplantation.

[0010] In an embodiment, the thiotepa composition comprises PEG such as PEG400 or PEG600. In another embodiment, the composition comprises DMSO. [0011] In an embodiment, the composition further comprises thiosulfate.

[0012] In an embodiment, there is provided a method for treating cancer in a subject, the method comprising injection administration of a composition comprising thiotepa, PEG or DMSO, and water. In a further embodiment, the PEG is PEG400 or PEG600. In a particular embodiment, the administered composition further comprises thiosulfate.

[0013] In another embodiment, there is provided a method for myeloablation of a subject prior to bone marrow transplantation comprising administration of the thiotepa composition.

[0014] In another embodiment, there is provided a method for enhancing the stability of a thiotepa preparation.

BRIEF DESCRIPTION OF THE DRAWINGS

[0015] The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure.

[0016] FIG. 1 shows chromatogram of a thiotepa composition of Example 1 .

DETAILED DESCRIPTION

[0017] The following description is merely exemplary in nature and is not intended to limit the present disclosure, application, or uses. [0018] The term “thiotepa” refers to the chemical compound N,N’,N”- triethylenethiophosphoramide, and is also known by the trade names of Tepadina® or Thioplex®.

Unless otherwise noted, thiotepa includes the compound itself and pharmaceutically acceptable salts thereof.

[0019] The term “non-aqueous” refers to compositions (e.g. solutions, liquids, or suspensions) which are free of or essentially free of water.

[0020] The term “subject” refers to an animal that can receive administration of the thiotepa composition. In some embodiments, the subject is human. In particular embodiments, the subject has, or is thought to have cancer. In another embodiment, the subject is in need of myeloablation or lymphodepletion prior to bone marrow transplantation or other therapy requiring a conditioning regimen. In another embodiment, the subject is in need of gene therapy.

[0021] The term “cancer” includes, but is not exclusive of, bladder cancer, malignant meningeal neoplasm, breast cancer, ovarian cancer, hematological malignancies, lymphoma, brain metastases, and leptomeningeal metastasis.

[0022] The term “injection” refers to a method of administration where the composition is administered to the body via needle. In an embodiment, the injection is selected from the group consisting of subcutaneous injection, intramuscular injection, intravenous injection, infusion, intraperitoneal injection, intrapleural injection, intrapericardial injection, intrathecal injection, intra-arterial injection, intravesical injection, and intralesional injection. The injection can be a single injection, including an acute injection or a continuous injection. The injection can be delivered over a number of days.

Compositions

[0023] The present disclosure provides a composition comprising thiotepa or its derivative, such as a metabolite, and one or more excipients. Such compositions include pharmaceutical compositions comprising thiotepa, PEG or DMSO, and water. Thiotepa is the active ingredient of the formulation and its amount can be adjusted as needed. Generally, all known/approved amounts of thiotepa can be used with the formulation. In an embodiment, the thiotepa is present in an amount of about 1 to about 100 mg/mL. In a further embodiment, the thiotepa is present in an amount of about 5 to about 50 mg. In a particular embodiment, the thiotepa is present at a concentration of about 10 mg/mL.

[0024] In an embodiment, the water is present at in an amount up to about 20% by weight. In another embodiment, the water is present in an amount of about 1 %, about 2%, about 3%, about 4%, about 5%, about 6%, about 7%, about 8%, about 9%, about 10%, about 11 %, about 12%, about 13%, about 14%, and about 15% by weight. In a particular embodiment, the water is present in an amount of about 10% by weight. In some embodiments, the water is distilled, purified, or ultrapurified. In another embodiment, the water may include saline or a phosphate buffer to prepare an isotonic solution.

[0025] In an embodiment, the composition comprises PEG in an amount of between about 80% to about 100%. In another embodiment, the PEG may be a PEG between PEG200 and PEG400. In a particular embodiment, the PEG is selected from PEG400 and PEG 600

[0026] In an alternate embodiment, the composition comprises dimethyl sulfoxide (DMSO) in an amount between about 90% to about 100%.

[0027] In another embodiment, the thiotepa composition further comprises thiosulfate. In a particular embodiment, the thiosulfate is present in an amount between about 0.01 % and about 1.0%, by weight. In still further embodiments, the thiosulfate is present in an amount of about 0.1 %, by weight.

[0028] The thiotepa composition can further comprise additional excipients and non-limiting examples of such excipients include buffers, antioxidants, and/or osmotic agents. In some embodiments, the antioxidant includes ascorbic acid, tocopherols, methionine (such as L-methionine), metabisulphite, propyl gallate, butylated hydroxyanasole, butylated hydroxytoluene, meglumine, thiosulphate salts. More preferred antioxidants are propyl gallate, thiosulphate salts, preferably sodium thiosulphate, and tocopherols, preferably a -tocopherols, more preferably a-tocopherol- PEG-succinate. a-tocopherol-PEG-succinate is a commercially available conjugate of a-tocopherol with PEG1000, and has high solubility in short PEGs. Most preferred antioxidants are thiosulphate salts, preferably sodium thiosulphate, and tocopherols, preferably a-tocopherols, more preferably a-tocopherol-PEG-succinate. In preferred embodiments is provided the composition according to the invention, further comprising an antioxidant such as a thiosulphate salt, propyl gallate, or a tocopherol. In more preferred embodiments is provided the composition according to the invention, further comprising an antioxidant selected from thiosulphate salt and/or a tocopherol. In most preferred embodiments is provided the composition according to the invention, further comprising an antioxidant selected from sodium thiosulphate and/or an a-tocopherol, preferably a-tocopherol-PEG-succinate

[0029] In a particular embodiment, the composition comprises about 1 to about 100 mg/mL thiotepa, PEG or DMSO, and up to about 20% water, by weight. If PEG is used, the PEG can be either PEG400 or PEG600. The composition may further comprise thiosulfate. Specific embodiments of the thiotepa composition are exemplified in Table 1 .

[0030] Table 1 : Thiotepa-containing formulations

[0031] In another embodiment, the thiotepa composition is in the form of a solution, suspension, or liquid. In a further embodiment, the thiotepa composition is an aqueous solution. In some embodiments, the compositions are in the form of a parenteral formulation suitable for injection.

[0032] In an alternative embodiment, the thiotepa is formulated in waterless compositions. In an embodiment, the waterless thiotepa composition comprises thiotepa and a solvent selected from the group consisting of DMSO, PEG400, PEG600, dimethayacetamide (DMA), and n-methyl-2-pyrrolidone (NMP). In another embodiment, the waterless thiotepa composition further comprises an antioxidant (such as tocopherol) and/or an organic base (such as Tris base). In a particular embodiment, the thioptepa composition comprises about 1 to about 100 mg/mL thiotepa, and DMSO, PEG400, PEG600, DMA, or NMP. Specific embodiments of the waterless thiotepa compositions are in Table 2.

[0033] Table 2: Waterless thiotepa-containing formulations

[0034] The composition of the present disclosure is to address, among other things, stability issues of thiotepa in an aqueous solution. Thiotepa is known to have stability issues in aqueous solutions, such as generation of impurities and degradation of the active ingredient during storage. The aqueous instability renders ready-to-use liquid dosage forms of thiotepa difficult to store. The stable thiotepa composition of the present disclosure is suitable for a ready-to-use liquid dosage drug product. In an embodiment, the thiotepa composition is stable at room temperature (e.g. 21-25°C) or under refrigeration (e.g. 4-5°C) for one month, two months, three months, or longer in the dark. In another embodiment, the thiotepa is stable for up to six months at room temperature (50% relative humidity) or under refrigeration. In a particular embodiment, the thiotepa composition is stored for a period of time, such as for 1 week, 2 weeks, 3 weeks, 4 weeks, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 1 year, 2 years, or 3 years.

Methods of treatment

[0035] The present disclosure provides various methods of using the thiotepa composition for the treatment of disease(s) such as cancer. In an embodiment, the thiotepa composition is administered to a subject to treat cancer, wherein the subject is in need of such treatment. Various cancers can be treated by the composition and in some embodiments, the cancer is selected from the group consisting of bladder cancer, malignant meningeal neoplasm, breast cancer, and ovarian cancer. In some other particular embodiments, the method is used for treating adenocarcinoma of the breast, controlling intracavitary effusions secondary to diffuse or localized, neoplastic diseases of various serosal cavities, and/or treating superficial papillary carcinoma of the urinary bladder. In an embodiment, the composition is used in combination with one or more chemotherapeutic agents for adult and pediatric subjects suffering from hematological diseases such as Hodgkin's disease and leukemia.

[0036] The thiotepa composition is administered to provide a therapeutically effective dose to achieve the goal or goals of the therapy. In some embodiments, the therapeutically effective amount is sufficient to treat cancer. In a particular embodiment, the therapeutically effective amount is between about 300 mg and about 700 mg. If a patient requires more than 850 mg thiotepa, the drug may be administered over two or more doses in a day. In another embodiment, the therapeutically effective amount of thiotepa is about between about 4 and about 20 mg/kg body weight. In an alternative embodiment, the therapeutically effective amount is between about 120 and about 300 mg/m² The thiotepa can be administered in a single day over the course of multiple days, such as over the course of between 1 and 5 days, in particular between 1 and 2 days. .

[0037] The thiotepa composition therapy can be combined with various cancer treatments known in the art. In an embodiment, the thiotepa composition is administered to the subject in conjunction with radiotherapy. In still another embodiment, the thiotepa composition is administered before, after, or concurrently with an additional chemotherapeutic agent. For the treatment of breast cancer or ovarian cancer, the therapeutically effective dose may be between about 20 mg and about 40 mg administered every 1 to 4 weeks.

[0038] In some embodiments, a therapeutically effective amount of thiotepa is administered to induce myeloablation prior to bone marrow transplantation. In a particular embodiment, the therapeutically effective amount of thiotepa is between 300 mg/mL and 700 mg/mL. In anotherembodiment, the therapeutically effective amount of thiotepa for myeloablation prior to bone marrow transplantation is provided over 1 to 5 days, or over 1 to 2 days. The total amount of thiotepa delivered over the course of treatment for myeloablation prior to bone marrow transplantation may be about 850 mg or more.

Method of enhancing stability

[0039] In an embodiment is provided a method for enhancing the stability of a thiotepa formulation. In an embodiment, the method comprises the steps of: combining thiotepa, water, and an excipient, wherein the excipient is PEG or DMSO; and homogenizing the combination. In some embodiments, the thiotepa concentration of the thiotepa in formulation following homogenization is between about 1 and about 100 mg/mL. In some embodiments, the water comprises between about 1 % and about 20%, by weight of the composition. In a particular embodiment, the thiotepa is present at about 10 mg/mL and the water is present at about 10% or 20%, by weight. In a particular embodiment, the PEG is PEG400 or PEG600. In a specific embodiment, the thiotepa formulation with enhanced stability consists of 10 mg/mL thiotepa, PEG 400, and 10% water, by weight. In a specific embodiment, the thiotepa formulation with enhanced stability consists of 10 mg/mL thiotepa, PEG 600, and 20% water, by weight. In a specific embodiment, the thiotepa formulation with enhanced stability consists of 10 mg/mL thiotepa, DMSO, and 10% water, by weight. In yet another embodiment, the formulation further comprises thiosulfate.

[0040] Further embodiments include:

[0041] 1. A composition comprising thiotepa, water, and an excipient, wherein the excipient is polyethylene glycol (PEG) or dimethylsulfoxide (DMSO).

[0042] 2. The composition of paragraph 1 , wherein the thiotepa is present in an amount between about 1 and about 100 mg/mL.

[0043] 3. The composition of paragraphs 1 or 2, wherein the thiotepa is present in an amount of about 10 mg/mL.

[0044] 4. The composition of paragraphs 1 or 2, wherein the excipient is PEG400 or PEG600.

[0045] 5. The composition of paragraphs 1 or 2, wherein the excipient is DMSO.

[0046] 6. The composition of any one of paragraphs 1 -5, further comprising thiosulfate.

[0047] 7. The composition of paragraph 6, wherein the thiosulfate is present in an amount of about 0.01 % to about 1 .0%. [0048] 8. The composition of paragraphs 6 or 7, wherein the thiosulfate is present in an amount of about 0.1 %.

[0049] 9. The composition of any one of paragraphs 1-8, wherein the water is present in an about up to about 20%.

[0050] 10. The composition of paragraph 9, wherein the water is present in an amount of about 10%.

[0051] 11 . The composition of paragraph 1 , which consists of thiotepa, PEG400, and water.

[0052] 12. The composition of paragraph 11 , which comprises about 10 mg/mL thiotepa and about 10% water, by weight.

[0053] 13. The composition of paragraph 1 , which consists of thiotepa, PEG600, and water.

[0054] 14. The composition of paragraph 13, which comprises about 10 mg/mL thiotepa and about 20% water, by weight.

[0055] 15. The composition of paragraph 1 , which consists of thiotepa, DMSO, and water.

[0056] 16. The composition of paragraph 15, which comprises about 10 mg/mL thiotepa and about 10% water, by weight.

[0057] 17. The composition of paragraph 1 , which comprises 10 mg/mL thiotepa,

PEG400, and 10% water, by weight.

[0058] 18. The composition of paragraph 1 , which comprises 10 mg/mL thiotepa,

PEG600, and 20% water, by weight. [0059] 19. The composition of paragraph 1 , which comprises 10 mg/mL thiotepa,

DMSO, and 10% water, by weight.

[0060] 20. The composition of paragraph 1 , which comprises 10 mg/mL thiotepa,

PEG400, 10% water, by weight, and 0.1 % thiosulfate.

[0061] 21 . The composition of paragraph 1 , which comprises 10 mg/mL thiotepa,

PEG600, 20% water, by weight, and 0.1 % thiosulfate.

[0062] 22. The composition of paragraph 1 , which comprises 10 mg/mL thiotepa,

DMSO, 10% water, by weight, and 0.1 % thiosulfate.

[0063] 23. The composition of any one of paragraphs 1 -10, further comprising tocopherol.

[0064] 24. A method for treating cancer in a subject in need thereof comprising: administering to the subject the composition of any one of paragraphs 1 to 23.

[0065] 25. The method of paragraph 24, wherein the cancer is selected from the group consisting of bladder cancer, malignant meningeal neoplasm, breast cancer, and ovarian cancer.

[0066] 26. The method of paragraph 24 or 25, wherein the composition is administered via injection.

[0067] 27. The method of paragraph 26, wherein the injection is selected from the group consisting of subcutaneous injection, intramuscular injection, intravenous injection, infusion, intraperitoneal injection, intrapleural injection, intrapericardial injection, intrathecal injection, intra-arterial injection, intravesical injection, and intralesional injection.

[0068] 28. The method of any one of paragraphs 24-27, comprising administering about 300 mg and about 700 mg thiotepa. [0069] 29. The method of any one of paragraphs 24-28, wherein the thiotepa is stabilized.

[0070] 30. A method for myeloablation prior to bone marrow transplant in a subject in need thereof comprising: administering to the subject the composition of any one of paragraphs 1 to 23.

[0071] 31. A method for enhancing the stability of a thiotepa formulation comprising: combining thiotepa, water, and a component selected from PEG and DMSO; and homogenizing the combination, wherein the concentration of thiotepa after the step of homogenizing is between about 1 and about 100 mg/mL, and wherein the water comprises between about 1 and about 20%, by weight, of the composition.

[0072] 32. The method of paragraph 31 , wherein the concentration of thiotepa is about 10 mg/mL.

[0073] 33. The method of paragraph 31 or 32, wherein the water comprises about

10% or about 20%, by weight, of the composition.

[0074] 34. The method of any one of paragraphs 31-33, wherein the PEG is

PEG400 or PEG600.

[0075] 35. The method of any one of paragraphs 31-34, wherein the thiotepa formulation consists of 10 mg/mL thiotepa, PEG400, and 10%, by weight, water.

[0076] 36. The method of any one of paragraphs 31-34, wherein the thiotepa formulation consists of 10 mg/mL thiotepa, PEG600, and 20%, by weight, water.

[0077] 37. The method of any one of paragraphs 31-33, wherein the thiotepa formulation consists of 10 mg/mL thiotepa, DMSO, and 10%, by weight, water.

[0078] 38. The method of any one of paragraphs 31-34, further comprising adding thiosulfate to the composition. [0079] 39. The method of paragraph 38, wherein the thiosulfate comprises about

0.01 % to about 10%, by weight.

[0080] 40. The method of paragraph 39, wherein the thiosulfate comprises about

0.1 %, by weight.

[0081] 41. A waterless composition comprising thiotepa and a solvent, wherein the solvent is selected from the group consisting of DMSO, PEG400, PEG600, DMA, and NMP.

[0082] 42. The waterless composition of paragraph 41 , further comprising an antioxidant or an organic base.

[0083] 43. The waterless composition of paragraph 42, wherein the antioxidant is tocopherol.

[0084] 44. The waterless composition of paragraph 42, wherein the organic base is Tris base.

EXAMPLES

[0085] Example 1 : Stability of aqueous thiotepa compositions

[0086] 100 mg thiotepa was weighted into an amber vessel with 10 mL PEG400,

PEG600, or DMSO (as appropriate) was added to the vessel. Purified water was added to the vessel at 10% (Examples 1 , 2, 5, and 6) or 20% (Examples 3 and 4) by weight. 0.1 % thiosulfate (by weight) was added to Examples 2, 4, and 6. The preparations were homogenized with a magnetic stirrer and stirred overnight. The preparations were aliquoted to separate vials and stored at 5°C or 25°C/60% relative humidity (RH).

[0087] The preparations were assayed by HPLC at 2 weeks, 1.5 months (6 weeks), 3.5 months, and 5 months. Relative standard deviation (RSD) was calculated for each sample. The total and chloroethyl impurities were also quantified by HPLC. HPLC was performed on a Waters, Xbridge shield Rp18, 75X4.6 mm, dp = 2.5 pm, with a flow of 1 .5 mL/min, an injection volume of 8 pL, and a run time of 12 minutes. [0088] Tables 3 and 4 show the stability of thiotepa formulations at 5°C and

25°C/60% RH, respectively.

[0089] Table 3: Thiotepa stability at 5°C (RSD is relative standard deviation)

[0090] Table 4: Thiotepa stability at 25°C/60% RH

[0091] As seen in the above tables, PEG and DMSO formulations with 10% or 20% water were stable when stored at 5°C. PEG400- and PEG600-containing formulations are stable up to 5 months, at both 5°C and 25°C/60% RH. FIG. 1 shows a chromatogram of a thiotepa composition of Example 1 .

[0092] Example 2: Stability of waterless thiotepa compositions

[0093] 100 mg thiotepa was weighted into an amber vessel with 10 mL PEG400, PEG600, DMSO, DMA, or NMP (as appropriate) was added to the vessel. Tocopherol and Tris base was included in some formulations The preparations were homogenized with a magnetic stirrer and stirred overnight. The preparations were aliquoted to separate vials and stored at 5°C or 25°C/60% RH.

[0094] The preparations were assayed by HPLC at 2 weeks, 1 month, and 2 months. Relative standard deviation (RSD) was calculated for each sample. The total and chloroethyl impurities were also quantified by HPLC. HPLC was performed on a Waters, Xbridge shield Rp18, 4.6x150 mm, dp = 3.5 pm, with a flow of 1 .0 mL/min, and an injection volume of 20 pL.

[0095] Tables 5 and 6 show the stability of thiotepa formulations at 5°C and 25°C/60% RH, respectively.

[0096] Table 5: Waterless thiotepa stability at 5°C

[0097] Table 6: Waterless thiotepa stability at 25°C/60% RH

[0098] The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure.

Claims

WHAT IS CLAIMED IS:

1. A composition comprising thiotepa, water, and an excipient, wherein the excipient is polyethylene glycol (PEG) or dimethylsulfoxide (DMSO).

2. The composition of claim 1 , wherein the thiotepa is present in an amount between about 1 and about 100 mg/mL.

3. The composition of claim 1 or 2, wherein the thiotepa is present in an amount of about 10 mg/mL.

4. The composition of claim 1 or 2, wherein the excipient is PEG400 or PEG600.

5. The composition of claim 1 or 2, wherein the excipient is DMSO.

6. The composition of any one of claims 1 -5, further comprising thiosulfate.

7. The composition of claim 6, wherein the thiosulfate is present in an amount of about 0.01 % to about 1 .0%.

8. The composition of claim 6 or 7, wherein the thiosulfate is present in an amount of about 0.1 %.

9. The composition of any one of claims 1-8, wherein the water is present in an about up to about 20%.

10. The composition of claim 9, wherein the water is present in an amount of about 10%.

11 . The composition of claim 1 , which consists of thiotepa, PEG400, and water.

12. The composition of claim 11 , which comprises about 10 mg/mL thiotepa and about 10% water, by weight.

13. The composition of claim 1 , which consists of thiotepa, PEG600, and water.

14. The composition of claim 13, which comprises about 10 mg/mL thiotepa and about 20% water, by weight.

15. The composition of claim 1 , which consists of thiotepa, DMSO, and water.

16. The composition of claim 15, which comprises about 10 mg/mL thiotepa and about 10% water, by weight.

17. The composition of claim 1 , which comprises 10 mg/mL thiotepa, PEG400, and 10% water, by weight.

18. The composition of claim 1 , which comprises 10 mg/mL thiotepa, PEG600, and 20% water, by weight.

19. The composition of claim 1 , which comprises 10 mg/mL thiotepa, DMSO, and 10% water, by weight.

20. The composition of claim 1 , which comprises 10 mg/mL thiotepa, PEG400, 10% water, by weight, and 0.1 % thiosulfate.

21 . The composition of claim 1 , which comprises 10 mg/mL thiotepa, PEG600, 20% water, by weight, and 0.1 % thiosulfate.

22. The composition of claim 1 , which comprises 10 mg/mL thiotepa, DMSO, 10% water, by weight, and 0.1 % thiosulfate.

23. The composition of any one of claims 1 -10, further comprising tocopherol.

24. A method for treating cancer in a subject in need thereof comprising: administering to the subject the composition of any one of claims 1 to 23.

25. The method of claim 24, wherein the cancer is selected from the group consisting of bladder cancer, malignant meningeal neoplasm, breast cancer, and ovarian cancer.

26. The method of claim 24 or 25, wherein the composition is administered via injection.

27. The method of claim 26, wherein the injection is selected from the group consisting of subcutaneous injection, intramuscular injection, intravenous injection, infusion, intraperitoneal injection, intrapleural injection, intrapericardial injection, intrathecal injection, intra-arterial injection, intravesical injection, and intralesional injection.

28. The method of any one of claims 24-27, comprising administering about 300 mg and about 700 mg thiotepa.

29. The method of any one of claims 24-28, wherein the thiotepa is stabilized.

30. A method for myeloablation prior to bone marrow transplant in a subject in need thereof comprising: administering to the subject the composition of any one of claims 1 to 23.

31 . A method for enhancing the stability of a thiotepa formulation comprising: combining thiotepa, water, and a component selected from PEG and DMSO; and homogenizing the combination, wherein the concentration of thiotepa after the step of homogenizing is between about 1 and about 100 mg/mL, and wherein the water comprises between about 1 and about 20%, by weight, of the composition.

32. The method of claim 31 , wherein the concentration of thiotepa is about 10 mg/mL.

33. The method of claim 31 or 32, wherein the water comprises about 10% or about 20%, by weight, of the composition.

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34. The method of any one of claims 31 -33, wherein the PEG is PEG400 or PEG600.

35. The method of any one of claims 31 -34, wherein the thiotepa formulation consists of 10 mg/mL thiotepa, PEG400, and 10%, by weight, water.

36. The method of any one of claims 31 -34, wherein the thiotepa formulation consists of 10 mg/mL thiotepa, PEG600, and 20%, by weight, water.

37. The method of any one of claims 31 -33, wherein the thiotepa formulation consists of 10 mg/mL thiotepa, DMSO, and 10%, by weight, water.

38. The method of any one of claims 31-34, further comprising adding thiosulfate to the composition.

39. The method of claim 38, wherein the thiosulfate comprises about 0.01 % to about 10%, by weight.

40. The method of claim 39, wherein the thiosulfate comprises about 0.1 %, by weight.

41 . A waterless composition comprising thiotepa and a solvent, wherein the solvent is selected from the group consisting of DMSO, PEG400, PEG600, DMA, and NMP.

42. The waterless composition of claim 41 , further comprising an antioxidant or an organic base.

43. The waterless composition of claim 42, wherein the antioxidant is tocopherol.

44. The waterless composition of claim 42, wherein the organic base is Tris base.

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