Nimustine + Procarbazine + Vincristine

The combination "nimustine + procarbazine + vincristine" is a chemotherapy regimen primarily used for treating high-grade gliomas (brain tumors). This combination was studied in a Phase II trial where it was administered during and after radiotherapy that was given immediately after hyperbaric oxygenation (HBO). It consists of three distinct agents: 1. **Nimustine**: A nitrosourea compound similar to lomustine (CCNU), which is an alkylating agent that works by damaging DNA in cancer cells. 2. **Procarbazine**: An alkylating agent that also damages DNA in cancer cells, preventing them from dividing. 3. **Vincristine**: A vinca alkaloid that disrupts microtubule formation, preventing cell division. The combination is similar to the PCV regimen (procarbazine, lomustine/CCNU, vincristine), differing in the use of nimustine instead of lomustine. In the Phase II trial, it showed a median overall survival of 20.2 months for all patients (17.2 months for glioblastoma patients and 113.4 months for Grade 3 glioma patients) and appeared safe with no serious nonhematologic or late toxicities observed in the 57 patients treated.