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Information about Carmustine

Carmustine (BCNU) is a parenterally administered alkylating agent used alone and in combination with other antineoplastic agents in the treatment of several forms of cancer including leukemias, lymphomas, and breast, testicular, ovarian, gastric and pancreatic cancer.

Liver safety of Carmustine

Carmustine therapy is associated with minor transient serum enzyme elevations and has been linked to cases of acute liver injury including cholestatic hepatitis and acute veno-occlusive disease.

Mechanism of action of Carmustine

Carmustine (kar mus' teen), which is also known as BCNU, is a nitrosourea that acts as an alkylating agent and is used in the therapy of several forms of leukemia, lymphoma and solid organ cancer. Like cyclophosphamide, carmustine requires activation in the liver to form its active intermediates which act by modifying and cross linking purine bases in DNA, thus inhibiting DNA, RNA and protein synthesis and leading to cell death in rapidly dividing cells. Carmustine also forms adducts with intracellular proteins.

FDA approval information for Carmustine

Carmustine was approved for use in the United States in 1977, and its current uses include treatment of breast, gastric, liver, pancreatic, lung, brain, ovarian and testicular cancer, malignant melanoma, Hodgkin and non-Hodgkin lymphoma and multiple myeloma. Carmustine is given intravenously and is available in liquid formulations (100 mg vials) in generic forms and under the trade names Gliadel or BiCNU.

Dosage and administration for Carmustine

Recommended dosess vary by age, body weight and malignant condition. Carmustine is often given in combination with other antineoplastic agents or alone in cycles every 6 to 8 weeks. It is also available formulated in a wafer containing 7.7 mg of carmustine (Gliadel), which can be inserted in a surgical space such as the brain after resection of a high grade malignant glioma. The toxicity of carmustine is similar to other alkylating agents.

Side effects of Carmustine

  • Common side effects include alopecia, nausea, vomiting, diarrhea, gastrointestinal upset, nephrotoxicity, oral ulcers and bone marrow suppression.

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