dacarbazine
Meaning of dacarbazine: One of the older cytotoxic drugs, still holding its place in Hodgkin lymphoma long after newer agents displaced it in melanoma.
Definition of dacarbazine
Dacarbazine is a chemotherapy drug given by vein that damages DNA so that dividing cells cannot copy it correctly. It is inactive as given and must be converted by the liver into the compound that does the work. It forms part of the standard combination for Hodgkin lymphoma and has long been used in advanced melanoma and in soft tissue sarcoma.
How does it work?
Dacarbazine belongs to the alkylating agent family, drugs that attach a small chemical group to DNA. The drug itself does nothing. Enzymes in the liver break it down to a short lived compound that tags one particular position on the base guanine. The cell attempts to repair the tag, and when it cannot, the damage halts replication and pushes the cell to destroy itself. Because the effect depends on cells dividing, tissues that renew quickly, such as bone marrow and the lining of the gut, take the collateral damage.
Which cancers is it used for?
| Disease | Role of the drug |
|---|---|
| Hodgkin lymphoma | The D of the ABVD combination, a first line regimen |
| Advanced melanoma | The long standing single agent, now largely displaced |
| Soft tissue sarcoma | Paired with doxorubicin |
| Some neuroendocrine tumors | Used in pancreatic types |
Its place in melanoma is a useful piece of history. For decades it was the only approved option for disease that had spread, responses were uncommon and rarely lasting, and every new drug was measured against it. Treatments that release the immune system and treatments aimed at specific mutations changed that picture. In Hodgkin lymphoma nothing displaced it.
What are the notable side effects?
Nausea and vomiting are severe without preventive medication, and dacarbazine sits among the strongest triggers of it in the whole class. The marrow is suppressed, so blood counts fall roughly one to two weeks after a dose and then recover. A flu like reaction with fever and aching can follow an infusion. Sensitivity to sunlight is described. The drug also irritates the vein it runs through and causes serious injury if it leaks into the tissue around the needle.
Also known as
Used in a sentence
Dacarbazine was given as part of ABVD for classical Hodgkin lymphoma.
Good to know
Dacarbazine has no activity until the liver converts it, so it acts as a prodrug, and it is a vesicant, meaning leakage outside the vein damages the surrounding tissue.