Bleomycin

Bleomycin

Clinical data
Pregnancy category	US: D (Evidence of risk)
Routes of administration	intramuscular and subcutaneous
ATC code	L01DC01 (WHO)
Legal status
Legal status	?
Pharmacokinetic data
Bioavailability	well absorbed
Metabolism	?
Elimination half-life	2 hours
Excretion	renal (60-70%)
Identifiers
CAS Number	11056-06-7
PubChem CID	456190
DrugBank	APRD00453
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}
Chemical and physical data
Formula	C55H84N17O21S3
Molar mass	1415.56

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Overview

Bleomycin is a glycosylated linear nonribosomal peptide antibiotic produced by the bacterium Streptomyces verticillus. Bleomycin refers to a family of structurally related compounds. When used as an anti-cancer agent, the chemotherapeutical forms are primarily bleomycin A₂ and B₂. Bleomycin A₂ is shown in the image. The drug is used in the treatment of Hodgkin lymphoma (as a component of the ABVD regimen), squamous cell carcinomas, and testicular cancer, pleurodesis as well as plantar warts.

History

See also: History of cancer chemotherapy

Bleomycin was first discovered in 1962 when the Japanese scientist Hamao Umezawa found anti-cancer activity while screening culture filtrates of S. verticullus. Umezawa published his discovery in 1966. The drug was launched in Japan by Nippon Kayaku in 1969. In the US bleomycin gained Food and Drug Administration (FDA) approval in July 1973. It was initially marketed in the US by the Bristol-Myers Squibb precursor Bristol Laboratories under the brand name Blenoxane.

Suppliers

Bristol-Myers Squibb still supplies Blenoxane. There are also generic versions of bleomycin available from Bedford, Sicor (Teva) and Mayne Pharma.

Mechanism of action

Bleomycin acts by induction of DNA strand breaks. Some studies suggest that bleomycin also inhibits incorporation of thymidine into DNA strands. DNA cleavage by bleomycin depends on oxygen and metal ions, at least in vitro. It is believed that bleomycin chelates metal ions (primarily iron) producing a pseudoenzyme that reacts with oxygen to produce superoxide and hydroxide free radicals that cleave DNA. In addition, these complexes also mediate lipid peroxidation and oxidation of other cellular molecules.

Side effects

The most serious complication of bleomycin is pulmonary fibrosis and impaired lung function. Other side effects include fever, rash, hyperpigmentation, alopecia, Raynaud's phenomenon, and ototoxicity.

See also

• Testicular cancer
• Hodgkin lymphoma
• Chemotherapy regimen
• History of cancer chemotherapy
• ABVD

References

• Claussen, C.A.; Long, E.C. (1999). "Nucleic Acid Recognition by Metal Complexes of Bleomycin". Chem. Rev. 99: 2797–2816. PMID 11749501.CS1 maint: Multiple names: authors list (link)