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Vinca alkaloids

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The vinca alkaloids include vincristine, vinblastine and vinorelbine which are important antineoplastic agents used in many chemotherapeutic regimens for a wide variety of cancers. Despite their cytotoxic activity against cancer cells, the vinca alkaloids have rarely been implicated in causing clinically apparent acute liver injury.

Mechanism of action of Vinca alkaloids

The vinca alkaloids are antineoplastic agents that act by binding to intracellular tubulin, the basic protein subunit of microtubules which are important in many intracellular processes including mitosis and cell division. The vinca alkaloids inhibit cell division by blocking mitosis; they also inhibit purine and RNA synthesis causing death of rapidly dividing cells. Vincristine and vinblastine were initially isolated from periwinkle (vinca rosea), extracts of which were found to have antitumor activity. Subsequently, they have been synthesized, although their structure is quite complex. Vinorelbine is a semisynthetic derivative of extracts of periwinkle.

FDA approval information for Vinca alkaloids

Vincristine (vin kris' teen) was approved for use in cancer chemotherapy in 1963, vinblastine (vin blas' teen) in 1965 and vinrelbine (vin or' el been) in 1994. They have become major components of many combination anticancer regimens, used particularly in treatment of acute leukemia, Hodgkin disease and other lymphomas, various sarcomas, Wilms tumor, neuroblastoma, and breast and lung cancer.

Dosage and administration for Vinca alkaloids

The vinca alkaloids are given intravenously, typically at one or two week intervals in cycles with other agents. The vinca alkaloids are available in generic forms and under the trade names Oncovin (vincristine), Velban (vinblastine) and Navelbine (Vinorelbine).

Side effects of Vinca alkaloids

Side effects are common and include nausea, vomiting, fatigue, headache, dizziness, peripheral neuropathy, hoarseness, ataxia, dysphagia, urinary retention, constipation, diarrhea, bone marrow suppression, alopecia and phlebitis at the infusion site.

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