dacarbazine


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Related to dacarbazine: doxorubicin, bleomycin, Temozolomide

dacarbazine

 [dah-kahr´-bah-zēn]
a cytotoxic alkylating agent, used in antineoplastic therapy primarily for treatment of malignant melanoma and in combination chemotherapy for Hodgkin's disease and sarcomas. Unlike other alkylating agents, its primary target is not DNA; its major effect is inhibition of RNA and protein synthesis. Called also DTIC.

dacarbazine

DTIC, DTIC-Dome

FDA Box Warning

Give under supervision of physician experienced in cancer chemotherapy.

Hematopoietic depression is most common toxicity; hepatic necrosis has also occurred.

Drug is carcinogenic and teratogenic in animals.

Prescriber must weigh potential benefit against toxicity risk.

Action

Unclear. Thought to inhibit DNA synthesis by acting as purine analog. Also causes alkylation and may interact with sulfhydryl groups.

Availability

Injection: 100-mg and 200-mg vials

Indications and dosages

Hodgkin's disease

Adults: 150 mg/m2 I.V. daily for 5 days in combination with other drugs, repeated q 4 weeks. Or 375 mg/m2 I.V. on first day of combination therapy, repeated q 15 days.

Metastatic malignant melanoma

Adults: 2 to 4.5 mg/kg I.V. daily for 10 days, repeated q 4 weeks. Or 250 mg/m2 I.V. daily for 5 days, repeated q 3 weeks.

Off-label uses

• Malignant pheochromocytoma

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:

• hepatic dysfunction, impaired bone marrow function

• pregnant or breastfeeding patients

• children.

Administration

• Follow facility procedures for safe handling, administration, and disposal of chemotherapeutic drugs.

• Reconstitute with sterile water for injection according to manufacturer's directions.

• Further dilute reconstituted drug with 5% dextrose in water or normal saline solution.

Administer over 30 to 60 minutes by I.V. infusion only.

Take steps to prevent extravasation, which may cause tissue damage and severe pain.

Adverse reactions

CNS: malaise, paresthesia

GI: nausea, vomiting, dyspepsia, anorexia

Hematologic: anemia, leukopenia, thrombocytopenia, bone marrow depression

Musculoskeletal: myalgia

Skin: dermatitis, erythematous or urticarial rash, alopecia, flushing, photosensitivity

Others: flulike symptoms, fever, hypersensitivity reactions including anaphylaxis

Interactions

Drug-diagnostic tests. Platelets, red blood cells, white blood cells: decreased counts

Drug-behaviors. Sun exposure: photosensitivity reaction

Patient monitoring

Frequently monitor CBC with white cell differential and platelet count. Know that hematopoietic depression is the most common toxicity and can be fatal.

• Assess infusion site closely for extravasation.

Patient teaching

Instruct patient to immediately report pain, burning, or swelling at infusion site; numbness in arms or legs; gait changes; respiratory distress; difficulty breathing; rash; or easy bruising or bleeding.

• Advise patient to minimize GI distress by eating small, frequent servings of healthy food and drinking plenty of fluids.

• Tell patient he'll undergo regular blood testing during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests and behaviors mentioned above.

dacarbazine

(dă-kär′bə-zēn′, dā-)
n.
An antineoplastic agent used in the treatment of malignant melanoma and Hodgkin lymphoma.

ABDIC

A "salvage" chemotherapy regimen used for patients who have a disease—e.g., lymphoma—relapse after radiation therapy or chemotherapy.

dacarbazine

Oncology An alkylating chemotherapeutic used for lymphoma and metastatic melanoma Adverse effects BM suppression, pain on administration, vomiting

dacarbazine

An alkylating cytotoxic anti-cancer drug. The drug is on the WHO official list. A brand name is DTIC-Dome.
References in periodicals archive ?
Bondarenko et al., "Ipilimumab plus dacarbazine for previously untreated metastatic melanoma," The New England Journal of Medicine, vol.
In the second phase III trial, previously untreated patients with metastatic melanoma were treated with ipilimumab plus dacarbazine versus dacarbazine alone.
Results of a prospective randomized clinical trial of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by radiation therapy (RT) versus ABVD alone for stages I, II, and IIIA non bulky Hodgkin disease.
According to the results of preplanned subgroup analyses of the duration of response in patients with liposarcoma and leiomyosarcoma, median duration of response for the eribulin treatment was 12.5 months [95% CI: 1.7-Not Estimable] and median duration of response for dacarbazine treatment was 4.2 months [95% CI: 2.2-14.7].
Methods: The B16F10 cell line was treated with different concentrations of saponin (O, 4, 8, 12, 16, 20 [micro]g/ml), dacarbazine (O, 1200, 1400, 1600, 1800, 2000 [micro]/ml) and coadministration of saponin-dacarbazine (1200 da+8 sp, 1200 da+4 sp) for 24 and 48 hr and the cytotoxic effect was examined by MTT, DAPI, acridine orange/propodium iodide, flow cytometry and caspase colorimetric assay.
Dacarbazine is chemotherapy used in cancer patients; its trade name is known as DETICENE, and have been purchased from (Medac, Germany).
In salvage therapy, the most effective chemotherapeutic agent is Dacarbazine, with response rates varying from 15% to 25% [20].
Bristol Myers Squibb, a global biopharmaceutical company, has reported positive results from a Phase III trial (CheckMate -066) comparing an investigational PD-1 immune checkpoint inhibitor, Opdivo, to the chemotherapy, dacarbazine, in patients with treatment naive BRAF wild-type advanced melanoma, it was reported yesterday.
MAID (Mesna, Doxorubicin, Ifosfamide, and Dacarbazine) regimen was started for the patient.
In a landmark phase 3 study by Chapman and colleagues, vemurafenib monotherapy showed an overall survival advantage when compared to dacarbazine in treatment-naive patients with advanced BRAF V600E mutated melanoma [10].
He received six cycles of chemotherapy containing bleomycin vinblastine doxorubicin and dacarbazine which ended 2 months ago.