fotemustine + procarbazine

Fotemustine + procarbazine is a combination chemotherapy regimen consisting of two alkylating agents, fotemustine and procarbazine. Fotemustine is a third-generation nitrosourea compound that exerts its antitumor effect by alkylating DNA and causing cross-linking, which leads to inhibition of DNA replication and cell death. Procarbazine is also an alkylating agent that works by inhibiting DNA, RNA, and protein synthesis through methylation of guanine residues in DNA. This combination has been studied primarily for the treatment of recurrent malignant gliomas (including high-grade gliomas) in patients who have failed prior therapies such as temozolomide. The regimen has demonstrated activity with partial responses and disease stabilization in clinical studies[1][2][5]. Toxicities include myelosuppression (notably thrombocytopenia and neutropenia), liver toxicity, deep vein thrombosis, pneumopathy, among others[5].