Prednimustine

Definition

Prednimustine is one of a group of antineoplastic (antitumor) drugs known as alkylating agents. As of mid-2001, it is an investigational drug .

Purpose

Prednimustine has been used in the treatment of chronic lymphocytic leukemia , non-Hodgkin's lymphomas , and other malignant conditions including breast cancer .

Description

Prednimustine is one of a group of drugs based on the mustard gas used as a weapon in World War I. Like many antineoplastic (antitumor) therapies, prednimustine acts by killing quickly growing cells. Since cancerous cells are generally growing faster than normal cells, drugs that kill quickly growing cells generally affect tumors more than normal cells. However, some normal cells, such as white blood cells and platelets, also grow quickly and can be severely affected by antineoplastic drugs. Antitumor therapies create a situation in which the drug is racing to kill the tumor before it causes irreparable damage to normal tissues. The ideal situation is one in which the growth of the tumor is severely affected, but the growth of normal cells is unaffected. However, not every situation is ideal. Some patients taking antitumor drugs may have to discontinue treatment due to the severity of the drug's side effects.

Prednimustine probably kills rapidly growing cells by modifying cell's DNA with a chemical structure called an alkyl group. Thus, it is included in the group of alkylating agents. Prednimustine is a combination of two drugs joined together: chlorambucil (an alkylating agent) and methylprednisolone (a steroid).

Prednimustine is an investigational drug in the United States. This means that the FDA has not approved this drug for marketing in the U.S. as of mid-2001. Generally, investigational drugs are made available through participation in research studies.

Many drugs have toxic side effects, some of which are difficult to detect. Clinical trials are used to determine the side effects, drug interactions, and precautions for medicines, as well as their efficacy. Successful completion of multi-step clinical trials results in FDA approval of a drug. Many drugs that are used in clinical trials never gain FDA approval, however, possibly because of severe side effects which outweigh the benefits of the medication, or because the medication does not perform the function for which it was tested. Final approval of a drug is also expensive. Some drugs may not receive the financial support necessary to achieve final approval.

Recommended dosage

Since prednimustine is investigational, there is no recommended dosage. Various dosing schedules have been reported in the literature for different cancers.

Precautions

Patients who take this drug should avoid pregnancy, since this drug may cause fetal abnormalities.

Side effects

In the published reports of prednimustine use, the most common side effect is myelosuppression , the damage to white blood cells and platelets. Such damage may result in infection and bleeding, respectively. Steroid side effects, such as fluid retention and high glucose, have also been reported.

Interactions

As of mid-2001, information on the interactions of prednimustine is not available.

See Also Chlorambucil

Michael Zuck, PhD

KEY TERMS

Investigational drug

—A drug that has not been approved for marketing by the FDA. These drugs are generally available to patients through participation in research studies.