Carmustine wafer, polifeprosan 20 (Gliadel wafer)

General information

Class/mechanism: Biodegradable copolymer matrix (polifeprosan 20) embedded with carmustine, a nitrosourea which alkylates DNA and RNA and inhibits several key enzymatic processes by carbamoylation of amino acids in proteins. Each Gliadel wafer is 1.45 cm in diameter and 1 mm thick and contains 192.3 mg copolymer and 7.7 mg carmustine. Exposure to the surgical resection cavity results in hydrolyzation of anhydride bonds of the copolymer, which releases carmustine.
Route: implanted wafer
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Glioblastoma
• High-grade glioma

Patient drug information

• Carmustine wafer, polifeprosan 20 (Gliadel) patient drug information (Chemocare)
• Carmustine wafer, polifeprosan 20 (Gliadel) patient drug information (UpToDate)

History of changes in FDA indication

• 9/23/1996: Inital FDA approval
• Current indications:
  • Newly diagnosed high-grade malignant glioma patients as an adjunct to surgery and radiation
  • Recurrent glioblastoma multiforme patients as an adjunct to surgery

Also known as

• Generic name: polifeprosan 20 with carmustine implant
• Brand name: Gliadel wafer