A sensitive method for the determination of Cloretazine (VNP40101M) and its metabolite (VNP4090CE) with an internal standard (ISTD) in human plasma was developed using high-performance liquid chromatographic separation with tandem mass spectrometric detection. Acidified plasma samples (500 microL) were prepared using solid phase extraction (SPE) columns, and 25 microL of the reconstituted sample was injected onto an Ascentis C18 HPLC column (3 microm, 5 cmx2.1 mm) with an isocratic mobile phase. Analytes were detected with an API-3000 LC-MS/MS System at unit (Q1) and low (Q3) resolution in negative multiple reaction monitoring mode: m/z 249.0 (precursor ion) to m/z 114.9 (product ion) for both Cloretazine (at 3.64 min) and VNP4090CE (at 2.91 min), and m/z 253.0 (precursor ion) to m/z 116.9 (product ion) for the ISTD. The mean recovery for Cloretazine (VNP40101M) and its metabolite (VNP4090CE) was greater than 87% with a lower limit of quantification of 1.0 ng/mL for Cloretazine (S/N=9.7, CV<or=12%) and 0.5 ng/mL for VNP4090CE (S/N=11.3, CV<or=9.7%). This method was validated over a linear range of 1.0-1000 ng/mL for Cloretazine and 0.5-100 ng/mL for VNP4090CE, and results from a five day validation study demonstrated good within-day and between-day precision and accuracy. This method has been used to measure plasma Cloretazine and its metabolite concentrations in a Phase I study in children with recurrent progressive or refractory primary brain tumors.