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Information about Plicamycin

Plicamycin, which was formerly known as mithramycin, is an antibiotic that is used as an anticancer agent in the therapy of testicular cancer.

Liver safety of Plicamycin

Plicamycin causes acute hepatic injury that arises within days of starting therapy, but is usually transient and asymptomatic and rarely leads to jaundice. Plicamycin has not been approved for use as cancer chemotherapy in the United States, but continues to be used on an investigational basis.

Mechanism of action of Plicamycin

Plicamycin (plye” ka mye’ sin), which was formerly known as mithramycin, is an antineoplastic antibiotic that was first isolated from fermentation extracts of Streptomyces plicatus. It acts by binding to helical double-stranded DNA and blocking RNA synthesis.

FDA approval information for Plicamycin

It has potent antitumor effects in vitro and has been evaluated in several solid tumors in humans. Because of its toxicities (including hepatotoxicities), it has not been approved for use in the United States. Nevertheless, plicamycin has distinctive and sometimes potent activities against germ cell and testicular cancers and continues to be investigated as an experimental therapy in patients with advanced and resistant forms of cancer. Plicamycin is also effective in reducing hypercalcemia associated with malignancy, probably by inhibition of osteoblast function, but its use has been replaced by less toxic approaches such as corticosteroids and bisphosphonates.

Dosage and administration for Plicamycin

For the treatment of cancer, plicamycin is administered intravenously in doses of 25 to 50 μg/kg daily for 5 to10 days in 2 to 6 monthly courses.

Side effects of Plicamycin

Side effects of plicamycin are common and often dose limiting, including bone marrow suppression, irritability, agitation, gastrointestinal upset, diarrhea, nausea, anorexia, weakness, fever, rash, epistaxis, bruising and hemorrhage.

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