Dacarbazine blocks the growth of cells. It is converted to 5-amino-imidazole-4-carboxamide and a positively charged methyl group that is responsible for its alkylating effect (that is, the ability to add a group of carbon atoms and hydrogen to organic macromolecules such as proteins and DNA).
The alkylating effect of dacarbazine appears to affect various mechanisms that lead to the block of cell growth. With regards to its anti-tumor activity, dacarbazine inhibits DNA synthesis and cell growth independent of the cell cycle.
What is Dacarbazine?
Dacarbazine is typically used by oncologists and hematologists for the treatment of metastasized malignant melanoma. It can also be administered in combination with chemotherapy for the treatment of:
- Advanced stages of Hodgkin's lymphoma
- Advanced stages of soft tissue sarcomas (only in adults and not in the case of mesothelioma or Kaposi's sarcoma)
How should Dacarbazine be taken?
The use of dacarbazine is typically reserved for intravenous administration. For doses of up to 200 mg/m² you can proceed with a slow intravenous injection, whereas an intravenous infusion is required for higher doses of variable duration between 15 and 30 minutes.
In general, the treatment of Hodgkin's lymphoma involves 6 cycles of therapy of ABVD combination, while in the case of malignant melanoma and metastatic soft tissue sarcoma, the duration varies according to the effectiveness of therapy and individual tolerability. In any case, your doctor will determine the duration of treatment based on the characteristics of the disease as well as the patient.
Side effects associated with Dacarbazine
The most common side effects associated with the use of dacarbazine include:
- Anorexia
- Nausea
- Vomiting
- Problems with the lymphatic system, such as anemia, leukopenia and thrombocytopenia or, more rarely, pancytopenia and agranulocytosis
Some of the less common side effects triggered by the administration of the medication include:
- Diarrhea
- Anaphylactic reactions
- Headaches
- Vision problems
- Confusion
- Lethargy
- Facial paraesthesia
- Convulsions
In rare cases dacarbazine may cause the following:
- Hepatic necrosis due to veno-occlusive disease (VOD) of the liver
- Impaired renal function
- Alopecia
- Hyperpigmentation and photosensitivity of the skin
- Erythema
- Maculopapular rash
- Irritation at the application site
- Increased liver enzymes (e.g. alkaline phosphatase)
Contraindications and warnings associated with the use of Dacarbazine
The dacarbazine is contraindicated in case of hypersensitivity to the active substance or to any ingredients of the medication. It is also contraindicated in people suffering from leukopenia, thrombocytopenia or severe kidney or liver disease. The use is not recommended in pediatric patients, in pregnancy and during breast-feeding.
Some studies have shown that dacarbazine exercises mutagenic, teratogenic and carcinogenic effects. Therefore, during treatment women should not become pregnant; men should instead use methods of contraception during therapy and for 6 months following treatment.
Therapy should be discontinued if it causes symptoms such as hypersensitivity reactions, and/or a liver or kidney dysfunction. In addition, the termination of treatment may be necessary in case of appearance of veno-occlusive disease of the liver, toxicity against white blood cells, red blood cells or platelets.
Finally, dacarbazine can affect your ability to drive or operate machinery, and during the treatment cycles you should avoid taking hepatotoxic drugs, and alcohol consumption.
