Difference between revisions of "Carmustine wafer, polifeprosan 20 (Gliadel wafer)"

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Also known as polifeprosan 20 with carmustine implant.
 
 
 
==General information==
 
==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.<ref name="insert">[http://www.gliadel.com/Docs/Pdf/201241R1_Gliadel_PI.pdf Carmustine wafer, polifeprosan 20 (Gliadel) package insert]</ref><ref>[http://hemonc.org/docs/packageinsert/carmustinewafer.pdf Carmustine wafer, polifeprosan 20 (Gliadel) package insert (locally hosted backup)]</ref><ref>[http://www.gliadel.com/ Gliadel manufacturer's website]</ref>
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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.<ref name="insert">[https://gliadel.com/hcp/media/_pdfs/prescribing-information-gliadel.pdf Carmustine wafer, polifeprosan 20 (Gliadel) package insert]</ref><ref>[[:File:Carmustinewafer.pdf | Carmustine wafer, polifeprosan 20 (Gliadel) package insert (locally hosted backup)]]</ref><ref>[http://www.gliadel.com/ Gliadel manufacturer's website]</ref>
 
<br>Route: implanted wafer
 
<br>Route: implanted wafer
 
<br>Extravasation: n/a
 
<br>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 [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref>  
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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 [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref>  
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==Diseases for which it is used==
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*[[Glioblastoma]]
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*[[:Category:High-grade gliomas|High-grade glioma]]
  
 
==Patient drug information==
 
==Patient drug information==
*[http://chemocare.com/BIO/carmustine_wafer.asp Carmustine wafer, polifeprosan 20 (Gliadel) patient drug information (Chemocare)]<ref>[http://chemocare.com/bio/carmustine.asp Carmustine wafer, polifeprosan 20 (Gliadel) patient drug information (Chemocare)]</ref>
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*[https://gliadel.com/hcp/media/_pdfs/prescribing-information-gliadel.pdf Carmustine wafer, polifeprosan 20 (Gliadel) package insert]<ref name="insert"></ref>
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*[https://chemocare.com/druginfo/carmustine-wafer.aspx Carmustine wafer, polifeprosan 20 (Gliadel) patient drug information (Chemocare)]<ref>[https://chemocare.com/druginfo/carmustine-wafer.aspx Carmustine wafer, polifeprosan 20 (Gliadel) patient drug information (Chemocare)]</ref>
 
*[http://www.uptodate.com/contents/carmustine-patient-drug-information Carmustine wafer, polifeprosan 20 (Gliadel) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/carmustine-patient-drug-information Carmustine wafer, polifeprosan 20 (Gliadel) patient drug information (UpToDate)]</ref>
 
*[http://www.uptodate.com/contents/carmustine-patient-drug-information Carmustine wafer, polifeprosan 20 (Gliadel) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/carmustine-patient-drug-information Carmustine wafer, polifeprosan 20 (Gliadel) patient drug information (UpToDate)]</ref>
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==History of changes in FDA indication==
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* 1996-09-23: Initial FDA approval
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* 2003-02-25 (oldest label available at Drugs @ FDA): indicated for newly diagnosed [[:Category:High-grade gliomas|high-grade malignant glioma]] patients as an adjunct to surgery and radiation
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* 2003-02-25 (oldest label available at Drugs @ FDA): indicated for recurrent [[glioblastoma|glioblastoma multiforme]] patients as an adjunct to surgery
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==History of changes in EMA indication==
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*1996-09-23: EURD
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==History of changes in PMDA indication==
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*2012-09-28: Initial approval for the treatment of [[:Category:High-grade gliomas|malignant glioma]].
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==Also known as==
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*'''Code names:''' NPC-08, NSC-409962, WR-139021
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*'''Generic name:''' polifeprosan 20 with carmustine implant
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*'''Brand names:''' Biodel, Gliadel wafer
  
 
==References==
 
==References==
 
<references/>
 
<references/>
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[[Category:Drugs]]
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[[Category:Intralesional medications]]
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[[Category:Locally delivered therapies]]
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[[Category:Nitrosoureas]]
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[[Category:Alkylating agents]]
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[[Category:Glioblastoma medications]]
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[[Category:High-grade glioma medications]]
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[[Category:FDA approved in 1996]]
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[[Category:EMA approved in 1996]]
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[[Category:PMDA approved in 2012]]

Latest revision as of 17:31, 26 November 2023

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.[1][2][3]
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.[1]

Diseases for which it is used

Patient drug information

History of changes in FDA indication

  • 1996-09-23: Initial FDA approval
  • 2003-02-25 (oldest label available at Drugs @ FDA): indicated for newly diagnosed high-grade malignant glioma patients as an adjunct to surgery and radiation
  • 2003-02-25 (oldest label available at Drugs @ FDA): indicated for recurrent glioblastoma multiforme patients as an adjunct to surgery

History of changes in EMA indication

  • 1996-09-23: EURD

History of changes in PMDA indication

Also known as

  • Code names: NPC-08, NSC-409962, WR-139021
  • Generic name: polifeprosan 20 with carmustine implant
  • Brand names: Biodel, Gliadel wafer

References