Fotemustine

{{Drugbox | Verifiedfields = changed | verifiedrevid = 477241123 | IUPAC_name = Ethyl 3,3-dimethyl-2-oxo-2-[[3-(2-chloroethyl)-3-nitrosoureido]oxy]propanoate | image = Fotemustine.svg | width = 200px | tradename = Muphoran | legal_status = Rx-only | routes_of_administration = Intravenous | ATC_prefix = L01 | ATC_suffix = AD05 | CAS_number = 92118-27-9 | PubChem = 45867 | DrugBank = DB04154 | ChemSpiderID = 41695 | UNII = 1Y1L2U4VEB | KEGG = D04101 | ChEMBL = 1201185 | C=9 | H=19 | Cl=1 | N=3 | O=5 | molecular_weight = 289.72 g/mol }}

Fotemustine is a chemotherapy drug used primarily in the treatment of malignant melanoma and certain types of brain tumors. It belongs to the class of alkylating agents, which work by adding an alkyl group to the DNA of cancer cells, thereby interfering with their ability to multiply.

Mechanism of Action

Fotemustine is a nitrosourea compound, similar to other drugs in its class such as carmustine and lomustine. It exerts its antitumor effects by alkylating the DNA of cancer cells, leading to DNA cross-linking and strand breaks. This ultimately results in the inhibition of DNA replication and cell division, causing cell death. The drug is particularly effective in crossing the blood-brain barrier, making it useful in treating brain tumors.

Clinical Use

Fotemustine is primarily indicated for the treatment of metastatic melanoma, especially when the cancer has spread to the brain. It is also used in the management of glioblastoma and other high-grade gliomas. The drug is administered intravenously, typically in a hospital setting, due to its potential side effects and the need for careful monitoring.

Side Effects

Common side effects of fotemustine include myelosuppression, which can lead to neutropenia, thrombocytopenia, and anemia. Patients may also experience nausea, vomiting, and fatigue. Due to its potential to cause severe bone marrow suppression, blood counts are closely monitored during treatment.

Pharmacokinetics

Fotemustine is rapidly absorbed and distributed throughout the body after intravenous administration. It is metabolized in the liver and excreted primarily through the kidneys. The drug's ability to penetrate the blood-brain barrier is a significant advantage in treating brain metastases.

Related Pages

• Chemotherapy
• Alkylating agent
• Malignant melanoma
• Brain tumor
• Nitrosourea