Carmustine (BCNU)

General information

Class/mechanism: Nitrosourea, alkylates DNA and RNA, inhibits several key enzymatic processes by carbamoylation of amino acids in proteins.
Route: IV
Extravasation: vesicant/irritant

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 established (work in progress)

• Peripheral T-cell lymphoma

Diseases for which it is used

• Anaplastic glioma
• CNS lymphoma
• Diffuse large B-cell lymphoma
• Follicular lymphoma
• Glioblastoma
• HIV-associated lymphoma
• Classical Hodgkin lymphoma
• Mantle cell lymphoma

Diseases for which is was used

• Breast cancer
• Melanoma
• Multiple myeloma

Patient drug information

• Carmustine (BiCNU) package insert
• Carmustine (BiCNU) patient drug information (Chemocare)
• Carmustine (BiCNU) patient drug information (UpToDate)

History of changes in FDA indication

• 1977-03-07: Initial FDA approval
• 2007-08-17 (oldest label available at Drugs @ FDA): indicated as palliative therapy as a single agent or in established combination therapy with other approved chemotherapeutic agents in brain tumors: glioblastoma, brainstem glioma, medulloblastoma, astrocytoma, ependymoma, and metastatic brain tumors. (No supporting studies are cited)
• 2007-08-17 (oldest label available at Drugs @ FDA): indicated as palliative therapy for multiple myeloma in combination with prednisone. (No supporting studies are cited)
• 2007-08-17 (oldest label available at Drugs @ FDA): indicated as palliative therapy for Hodgkin’s Disease as secondary therapy in combination with other approved drugs in patients who relapse while being treated with primary therapy, or who fail to respond to primary therapy. (No supporting studies are cited)
• 2007-08-17 (oldest label available at Drugs @ FDA): indicated as palliative therapy for Non-Hodgkin’s lymphomas as secondary therapy in combination with other approved drugs for patients who relapse while being treated with primary therapy, or who fail to respond to primary therapy. (No supporting studies are cited)

History of changes in EMA indication

• 1974-04-23: EURD

Also known as

• Generic names: BCNU, bischloroethylnitrosourea, carmustin
• Brand names: Becenun, BiCNU, Carmubris, Leucerom, Nitrourean, Nitrumon