procarbazine + tamoxifen

Procarbazine + tamoxifen is a combination regimen of two small molecule drugs used primarily as a second-line treatment for high-grade gliomas, including glioblastoma multiforme and anaplastic astrocytoma, particularly in patients who have relapsed after standard therapies. Procarbazine is an alkylating agent that inhibits DNA, RNA, and protein synthesis by causing DNA strand breaks and mispairing. Tamoxifen is a selective estrogen receptor modulator (SERM) that acts as an antagonist on estrogen receptors in breast tissue but can also exert other effects in different tissues. In the context of high-grade gliomas, this combination has shown moderate response rates but does not significantly improve time to progression or overall survival compared to historical controls. The regimen may improve quality of life or performance status for some patients[1][2].