Bleomycin

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Bleomycin (blee-oh-MY-sin) is the active ingredient in a drug used to treat many types of cancer, including Hodgkin lymphoma, [[non-Hodgkin lymphoma[[, penile cancer, testicular cancer, and squamous cell carcinoma of the cervix, head and neck, and vulva. It is also used to treat malignant pleural effusion. It is also being studied in the treatment of other types of cancer. Bleomycin comes from the bacterium Streptomyces verticillus. It damages the cell’s DNA and may kill cancer cells. It is a type of antineoplastic antibiotic.

Information about Bleomycin

Bleomycin is a cystotoxic antibiotic that is used as an anticancer agent in the therapy of testicular and germ cell cancers, Hodgkin disease, lymphomas and tumors of the head and neck.

Liver safety of Bleomycin

Therapy with bleomycin in combination with other agents is often associated with mild-to-moderate serum enzyme elevations, but is a rare cause of clinically apparent liver injury.

Mechanism of action of Bleomycin

The bleomycins are a group of glycopeptide antibiotics that were initially derived from Streptomyces verticillus and later found to have antitumor activity in vitro and in vivo. Bleomycin (blee” oh mye’ sin) is actually a mixture of water soluble glycopeptides that have similar chemical structures and metabolic activities. The cytotoxic effects of bleomycin appear to be due to oxidative damage to DNA, leading to single and double stranded breaks. Bleomycin is concentrated in skin and lung tissue and has significant cutaneous and pulmonary toxicity, but has only mild myelo- and immunosuppressive activities which allows it to be added to regimens that are otherwise limited by these toxicities.

FDA approval information for Bleomycin

Bleomycin was approved for use in the United States in 1973 and current formal indications include testicular and ovarian germ cell tumors, head and neck cancers, Hodgkin and non-Hodgkin lymphomas and malignant pleural effusions. It is usually given in combination with other anticancer agents, most frequently with cisplatin, vinblastine, etoposide, adriamycin or dacarbazine.

Brand name for Bleomycin

Bleomycin is available as a solution or lyophilized powder for injection in vials of varying concentrations generically and under the commercial name Blenoxane.

Dosage and administration for Bleomycin

The typical dose of bleomycin varies by indication and is adjusted for body weight and renal function. Bleomycin can be given intravenously, intramuscularly or subcutaneously, or instilled into the pleural space for malignant pleural effusions or into the bladder as local treatment for bladder cancer.

Side effects of Bleomycin

Common side effects of bleomycin include nausea, diarrhea, headache, dizziness, alopecia, fatigue and weakness. Uncommon, but serious toxicities of bleomycin include interstitial pneumonitis, hypersensitivity reactions and malignant hyperthermia that can be fatal.


Antineoplastic Agents

Alkylating Agents - Altretamine, Bendamustine, Busulfan, Carmustine, Chlorambucil, Cyclophosphamide, Dacarbazine, Ifosfamide, Lomustine, Mechlorethamine, Melphalan, Procarbazine, Streptozocin, Temozolomide, Thiotepa, Trabectedin

Platinum Coordination Complexes - Carboplatin, Cisplatin, Oxaliplatin

Antibiotics Cytotoxic - Bleomycin, Dactinomycin, Daunorubicin, Doxorubicin, Epirubicin, Idarubicin, Mitomycin, Mitoxantrone, Plicamycin, Mithramycin, Valrubicin

Antimetabolites Antifolates - Methotrexate, Pemetrexed, Pralatrexate, Trimetrexate

Purine Analogues - Azathioprine, Cladribine, Clofarabine, Fludarabine, Mercaptopurine, Nelarabine, Pentostatin, Thioguanine

Pyrimidine Analogues - Azacitidine, Capecitabine, Cytarabine, Decitabine, Floxuridine, Fluorouracil, Gemcitabine, Trifluridine/Tipracil

Biologic Response Modifiers - Aldesleukin (IL-2), Denileukin Diftitox, Interferon gamma

Histone Deacetylase Inhibitors - Belinostat, Panobinostat, Romidepsin, Vorinostat

Hormonal Agents Antiandrogens - Abiraterone, Bicalutamide, Cyproterone, Enzalutamide, Flutamide, Nilutamide

Antiestrogens (including Aromatase Inhibitors) - Anastrozole, Exemestane, Fulvestrant, Letrozole

Selective Estrogen Receptor Modulators - Raloxifene, Tamoxifen, Toremifene

Gonadotropin Releasing Hormone Analogues - Degarelix, Goserelin, Histrelin, Leuprolide, Triptorelin

Peptide Hormones - Lanreotide, Octreotide, Pasireotide

Monoclonal Antibodies - Alemtuzumab, Atezolizumab, Avelumab, Bevacizumab, Blinatumomab, Brentuximab, Cetuximab, Daratumumab, Dinutuximab, Durvalumab, Elotuzumab, Gemtuzumab, Inotuzumab Ozogamicin, Ipilimumab, Necitumumab, Nivolumab, Ofatumumab, Olaratumab, Panitumumab, Pembrolizumab, Pertuzumab, Ramucirumab, Rituximab, Tositumomab, Trastuzumab

Protein Kinase Inhibitors - Abemaciclib, Acalabrutinib, Afatinib, Alectinib, Axitinib, Bortezomib, Bosutinib, Brigatinib, Cabozantinib, Carfilzomib, Ceritinib, Cobimetinib, Copanlisib, Crizotinib, Dabrafenib, Dasatinib, Enasidenib, Erlotinib, Gefitinib, Ibrutinib, Idelalisib, Imatinib, Ivosidenib, Ixazomib, Lapatinib, Lenvatinib, Neratinib, Nilotinib, Niraparib, Olaparib, Osimertinib, Palbociclib, Pazopanib, Ponatinib, Regorafenib, Ribociclib, Rucaparib, Ruxolitinib, Sonidegib, Sorafenib, Sunitinib, Trametinib, Vandetanib, Vemurafenib, Vismodegib

Taxanes - Cabazitaxel, Docetaxel, Paclitaxel

Topoisomerase Inhibitors - Etoposide, Irinotecan, Teniposide, Topotecan

Tyrosine Kinase Receptor Inhibitors See Protein Kinase Inhibitors

Vinca Alkaloids - Vinblastine, Vincristine, Vinorelbine

Miscellaneous - Asparaginase (Pegaspargase), Bexarotene, Eribulin, Everolimus, Hydroxyurea, Ixabepilone, Lenalidomide, Mitotane, Omacetaxine, Pomalidomide, Temsirolimus, Thalidomide, Venetoclax


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