II. Indications

  1. FDA Approved
    1. Metastatic Islet Cell Cancer (Pancreas)
  2. Off-Label
    1. Adrenal cancer (metastatic)
    2. Carcinoid Tumor (metastatic)

III. Mechanism

  1. See Alkylating Agent
  2. Antineoplastic methyl-nitrosourea isolated from the bacterium Streptomyces achromogenes
  3. Alkylating Agent that cross-links DNA during all cell cycle phases and inhibts DNA synthesis
  4. Glucose sub-component allows for preferential uptake by pancreatic beta cells

IV. Medications

  1. Intravenous: 1 g vial

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Extravasation
    1. Skin necrosis
  2. Secondary Malignancy
  3. Nephrotoxicity
    1. Maximize hydration to prevent Renal Injury
  4. Hepatotoxicity
  5. Hypoglycemia
  6. Impaired future fertility
  7. Alopecia
  8. Diabetes Mellitus
    1. Diabetes Mellitus may be induced with high dose Streptozocin
  9. Minimal myelosuppression
    1. Contrast with other nitrosurea Antineoplastic Agents
    2. However, may result in Anemia

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (contraindicated in all trimesters)
    1. Teratogenic and adverse outcomes
    2. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Renal Function tests
    3. Liver Function Tests

Images: Related links to external sites (from Bing)

Related Studies