Isophosphamide is primarily used in cancer chemotherapy, particularly in the treatment of solid tumors such as testicular, ovarian, breast, and lung cancers. It functions as an alkylating agent, interfering with DNA replication in rapidly dividing cancer cells, which leads to cell death. Due to its mechanism, it is often included in combination therapy regimens to enhance treatment efficacy. Its use requires careful monitoring because of potential side effects, including bone marrow suppression and bladder toxicity, which may necessitate co-administration of protective agents like mesna. Isophosphamide is typically administered intravenously under controlled clinical settings.