dactinomycin (DAK-tih-noh-MY-sin) is a drug used to treat Ewing sarcoma, gestational trophoblastic tumor, Wilms tumor, and certain types of testicular cancer. It is also used to treat rhabdomyosarcoma in children. It is being studied in the treatment of other types of cancer. Dactinomycin comes from the bacterium Streptomyces parvulus. It damages the cell’s DNA and may kill cancer cells. It is a type of anticancer antibiotic. Also called actinomycin D and Cosmegen.
Information about Dactinomycin
Liver safety of Dactinomycin
In high doses, dactinomycin can cause severe liver injury including sinusoidal obstruction syndrome.
Mechanism of action of Dactinomycin
Dactinomycin (dak” tin oh mye’ sin) is one of the actinomycins, anticancer antibiotics that were discovered by Selman Waksman and colleagues in the 1940s using fermentation exacts from bacteria (Streptomyces). The actinomycins are chromopeptides which bind to double-helical DNA and interrupt RNA transcription, causing cell arrest and inhibition of cell division. Actinomycin D, later named dactinomycin, was isolated from Streptococcus parvullus and was identified as a promising antineoplastic agent. Subsequently, dactinomycin was shown to have antitumor effect against a broad array of solid tumors.
FDA approval information for Dactinomycin
Dactinomycin was formally approved for use in the United States in 1964 and continues to be a valuable agent in the therapy of solid tumors of childhood (Wilms tumor, rhabdomyosarcoma) and in choriocarcinoma in adult women. Dactinomycin is available as a solution or lyophilized powder for injection in vials of varying concentrations under the commercial name Cosmegen and must be given by the intravenous route, avoiding tissue extravasation.
Dosage and administration for Dactinomycin
The dose is based upon indication and body weight; a typical regimen is 10 to 15 mcg/kg daily for 5 days, with repeat courses every 2 to 4 weeks based upon tolerance and antitumor effects. Dactinomycin can also be given as a component of regional perfusion regimens for solid malignancies.
Side effects of Dactinomycin