Information about Lomustine
Lomustine is an orally administered alkylating agent used alone and in combination with other antineoplastic agents in the treatment of several malignancies including Hodgkin disease, lymphoma, and brain cancer.
Liver safety of Lomustine
Lomustine therapy is associated with minor transient serum enzyme elevations and has been linked to rare cases of clinically apparent acute liver injury.
Mechanism of action of Lomustine
Lomustine (loe mus' teen: also known as CCNU) is a nitrosourea similar to carmustine (BCNU), which acts as an alkylating agent and is used in the therapy of several forms of lymphoma and solid organ cancer. Like cyclophosphamide, lomustine requires activation in the liver to form its active intermediaries which act by modifying and cross linking purine bases in DNA, thus inhibiting DNA, RNA and protein synthesis and leading to programmed cell death (apoptosis) in rapidly dividing cells. Lomustine also forms adducts with cellular proteins. Lomustine was approved for use in the United States in 1977, and its current indications include treatment of brain cancer, and Hodgkin and non-Hodgkin lymphomas. Lomustine is available as capsules of 10, 40 and 100 mg in generic forms and under the trade name CeeNU.
Dosage and administration for Lomustine
Recommended doses vary by age, body weight and malignant condition. Lomustine is usually given in combination with other antineoplastic agents in a single oral dose of 100-130 mg/m2 in cycles every 6 to 8 weeks. The toxicity of lomustine is similar to other alkylating agents.
Side effects of Lomustine
- Common side effects include alopecia, nausea, vomiting, diarrhea, gastrointestinal upset, nephrotoxicity, oral ulcers and bone marrow suppression.