BCNU + misonidazole

BCNU + misonidazole is a combination therapy consisting of BCNU (carmustine), a nitrosourea alkylating agent used in chemotherapy, and misonidazole, a radiosensitizer and chemosensitizer from the nitroimidazole class. This combination has been investigated primarily for the treatment of recurrent malignant gliomas and other solid tumors. The rationale for combining these agents is that misonidazole can sensitize hypoxic tumor cells to the cytotoxic effects of chemotherapeutic agents like BCNU, potentially enhancing antitumor efficacy. Misonidazole may also alter the pharmacokinetics or metabolism of co-administered drugs; however, clinical studies have shown no significant pharmacokinetic interaction between BCNU and misonidazole in humans[1]. The combination increases toxicity (notably myelosuppression and weight loss) compared to monotherapy[2]. Mechanistically, carmustine acts by alkylating DNA and RNA leading to cell death, while misonidazole sensitizes hypoxic tumor cells by mimicking oxygen's effect on radiation damage or possibly interfering with cellular repair mechanisms.

Other names

carmustine + misonidazolebis-chloroethylnitrosourea + misonidazole