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This is a combination regimen of two drugs, carmustine (BCNU) and tamoxifen. Carmustine is an alkylating agent used primarily in the treatment of brain tumors, multiple myeloma, Hodgkin lymphoma, and non-Hodgkin lymphoma. Tamoxifen is a selective estrogen receptor modulator (SERM) that acts as an antiestrogen in breast tissue but can have estrogenic effects elsewhere. The combination has been studied for use in metastatic melanoma and other cancers. In clinical studies, the addition of tamoxifen to regimens containing BCNU (and often other agents like cisplatin and dacarbazine) was associated with higher response rates compared to regimens without tamoxifen; however, it also increased the risk of thromboembolic events such as deep venous thrombosis and pulmonary embolism[7]. The rationale for combining these agents includes potential synergistic effects—tamoxifen may enhance cytotoxicity through mechanisms beyond estrogen receptor antagonism, possibly including calcium channel blockade.
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