USMLE

Procarbazine

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Oncology Pharm
  1. Bleomycin
  2. Dactinomycin, Actinomycin D
  3. Doxorubicin, Daunorubicin
  4. Azathioprine, 6-MP
  5. Cladribine
  6. Cytarabine
  7. Busulfan
  8. Cyclophosphamide, Ifosfamide
  9. Nitrosoureas
  10. Paclitaxel
  11. Vincristine, Vinblastine
  12. Cisplatin, Carboplatin, Oxaliplatin
  13. Etoposide, Teniposide
  14. Irinotecan, Topotecan
  15. Bevacizumab
  16. Erlotinib
  17. Cetuximab, Panitumumab
  18. Imatinib, Dasatinib
  19. Rituximab
  20. Bortezomib, Carfilzomib
  21. Trastuzumab
  22. Dabrafenib, Vemurafenib
  23. Raloxifene and Tamoxifen
  24. Hydroxyurea
  25. Procarbazine

Summary

Procarbazine is a cancer therapy that works as an alkylating agent, forming cross-links between different strands of DNA that inhibit DNA synthesis and cell proliferation. Procarbazine is classically used as a chemotherapy to treat Hodgkin’s Lymphoma. Lastly, procarbazine is known to cause a disulfiram-like reaction to alcohol. That is, when combined with alcohol, procarbazine produces rapid-onset hangover-like effects.

Key Points

  • Procarbazine
    • Mechanism
      • Alkylating agent
        • Full mechanism unknown; thought to create linkages in DNA strands that prevent replication and transcription
        • Kills cells at all stages of the cell cycle (cell-cycle non-specific)
    • Clinical Use
      • Hodgkin’s lymphoma
        • Part of BEACOPP and MOPP combination regimens
      • Also used to treat CNS tumors
        • Primary CNS lymphoma
        • Glioblastoma multiforme
        • Anaplastic oligodendroglioma/oligoastrocytoma
        • Low-grade gliomas
    • Adverse Effects
      • Disulfiram-like reaction
        • Flushing, nausea, vomiting, headache with alcohol consumption
      • Bone marrow suppression
        • Seen in nearly all chemotherapies
      • Pulmonary toxicity (pneumonitis)
      • Increased risk of leukemia