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Procarbazine is a chemotherapy medication used for the treatment of Hodgkin lymphoma and brain cancers.

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Common side effect include low blood cell counts and vomiting. It is not recommended in people with severe liver or kidney problems. In the United Kingdom a month of treatment cost the National Health Service 450 to 750 pounds.

Medical uses

When used to treat Hodgkin lymphoma, it is often delivered as part of the BEACOPP regimen that includes bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine (tradename Oncovin), prednisone, and procarbazine. The first combination chemotherapy developed for Hodgkin lymphoma (HL), MOPP also included procarbazine (ABVD has supplanted MOPP as standard first line treatment for HL, with BEACOPP as an alternative for advanced/unfavorable HL). Alternatively, when used to treat certain brain tumors (malignant gliomas), it is often dosed as PCV when combined with lomustine (often called CCNU) and vincristine.

Dose is adjusted for kidney disease or liver disease.

Side effects

Very common (greater than 10% of people experience them) adverse effects include loss of appetite, nausea and vomiting. a progressive, enduring, often irreversible tingling numbness, intense pain, and hypersensitivity to cold, beginning in the hands and feet and sometimes involving the arms and legs.

Pharmacology

Procarbazine works, in part, as an alkylating agent and methylates guanine at the O-6 position (much like dacarbazine also does). Guanine is one of the four nucleotides that makes up DNA. The methylated DNA is prone to breakage, and RNA and protein synthesis is inhibited. Proliferating cancer cells need to replicate their DNA and undergo programmed cell death (apoptosis) in response to DNA strand breaks. Normal or non-proliferating cells are more apt to repair the DNA damage, but still some of the healthy cells will be damaged. Procarbazine is metabolized in the liver to an azo-derivative and then further metabolized by the cytochrome P-450 system to an active azoxy-derivative.

References

  • MOPP Treatment Regimen
  • PCV Information
  • Procarbazine Drug Information Provided by Lexi-Comp – Merck Manual
  • RX Listing for Matulane