Procarbazine (chemotherapy agent)

Skeletal formula of procarbazine

Procarbazine is an anticancer chemotherapy drug that has been in use for over four decades. In that time it has featured prominently in combination regimens for the treatment of lymphoma.

Drug profile

Class: Alkylating agent
Mechanism of action: It is believed that procarbazine works like other agents of its class, by adding an alkyl group to the cell, causing DNA damage and inducing cell death.
Treatment type: Chemotherapy
US approval: 1969
Synonyms: Matulane, Natulan
FDA Use-in-Pregnancy Rating: Category D

What procarbazine is effective for and why

Procarbazine is chiefly used in the treatment of Hodgkins lymphoma (and to a lesser extent, non-Hodgkins lymphoma), and in some brain cancers, including medulloblastoma and retinoblastoma. It is featured in numerous combination chemotherapy regimens for these diseases, including MOPP, COPP, BEACOPP, ChlVPP, PCV and 8-in-1, to name a few.

Procarbazine side effects: Overview

While each patient will have his or her own experiences with the side effects of procarbazine, most patients will likely experience myelosuppression, bleeding or bruising, stomatitis, hemolysis, nausea and/or vomiting, anorexia, constipation, diarrhea, neuropathy, hair loss, hypotension, and jaundice. Most if not all of these side effects should subside when one is finished with receiving procarbazine. Patients are encouraged to report all side effects to their oncologist or oncology team.

Further significant issues related to procarbazine include possible secondary cancers as well as potential reproductive dysfunction or infertility or sterility, especially in patients over aged 25.

Sources

Boyiadzis, Michael M. et al. Hematology-Oncology Therapy. 2007. New York: McGraw Hill, Medical Publishing Division.
Merck Manuals: Procarbazine
Cancer Drug Manual, BC Cancer Agency
Perry, Michael C, Editor. Companion Handbook to the Chemotherapy Sourcebook. 1999. Baltimore; Williams & Wilkins.
Drugs.com: Procarbazine

Significant studies relating to procarbazine

Spies SK et al. Procarbazine (Natulan) in the treatment of Hodgkin's disease and other lymphomas. S Afr Med J. 1966 Dec 10;40(44):1061-4.
McElwain TJ et al. A combination of chlorambucil, vinblastine, procarbazine and prednisolone for treatment of Hodgkin's disease. Br J Cancer. 1977 Aug;36(2):276-80.
Levin VA et al. Modified procarbazine, CCNU, and vincristine (PCV 3) combination chemotherapy in the treatment of malignant brain tumors. Cancer Treat Rep 1980 Feb-Mar;64(2-3):237-44.

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