procarbazine

Overview

Procarbazine is a hydrazine-derived alkylating agent that inhibits DNA, RNA, and protein synthesis; it is active against CNS tumors and crosses the blood-brain barrier. It is most commonly used as the “P” component of the PCV regimen (procarbazine, lomustine, vincristine) for anaplastic oligodendroglioma and other gliomas, often in combination with radiotherapy.

Evidence in the corpus

• Component of PCV (procarbazine/lomustine/vincristine) induction, which served as the historical comparator arm in a phase II trial (NCT00588523) for newly diagnosed 1p/19q-codeleted anaplastic oligodendroglioma (ODG3) and oligoastrocytoma (n=20 prior PCV cohort). In an exploratory cross-trial comparison using the same myeloablative HDC-ASCT backbone, single-agent temozolomide induction was non-inferior to PCV induction for OS (HR 3.38 favoring TMZ, P=0.005, all patients; HR 5.68, P=0.018, 1p/19q-codeleted) — countering concerns that TMZ is inferior to PCV in this disease. PMID:28472509

Resistance mechanisms

• Not specifically reported in the corpus.

Cancer types (linked)

• ODG3 — procarbazine as P in PCV induction comparator arm for 1p/19q-codeleted anaplastic oligodendroglioma HDC-ASCT trial; non-inferior to single-agent TMZ in exploratory cross-trial comparison.

Sources

• PMID:28472509 — Thomas et al. 2017, J Clin Oncol. Phase II NCT00588523; procarbazine as component of PCV induction in 1p/19q-codeleted anaplastic oligodendroglioma; TMZ found non-inferior to PCV in cross-trial comparison.

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