Carmustine is sometimes used in conjunction with alkyl guanine transferase (AGT) inhibitors, such as O6-benzylguanine. The AGT-inhibitors increase the efficacy of carmustine by inhibiting the direct reversal pathway of DNA repair, which will prevent formation of the interstrand crosslink between the N1 of guanine and the N3 of cytosine.
In the treatment of brain tumours, the U.S. Food and Drug Administration (FDA) approved biodegradable discs infused with carmustine (Gliadel).[11] They are implanted under the skull during a surgery called a craniotomy. The disc allows for controlled release of carmustine in the extracellular fluid of the brain, thus eliminating the need for the encapsulated drug to cross the blood-brain barrier.[12]
Production
Carmustine for injection was marketed under the name BiCNU by Bristol-Myers Squibb[13] and now[when?] by Emcure Pharmaceuticals.[14] In India it is sold under various brand names, including Consium.[citation needed]. The product is available as a generic version with other manufacturers offering the product licensed in the US and EU markets.[citation needed]
^Silverman RB, Holladay MW (January 2014). "Chapter 6 - DNA-Interactive Agents". In Silverman RB, Holladay MW (eds.). The Organic Chemistry of Drug Design and Drug Action (Third ed.). Boston: Academic Press. pp. 275–331. doi:10.1016/b978-0-12-382030-3.00006-4. ISBN978-0-12-382030-3.
^Ewend MG, Brem S, Gilbert M, Goodkin R, Penar PL, Varia M, et al. (June 2007). "Treatment of single brain metastasis with resection, intracavity carmustine polymer wafers, and radiation therapy is safe and provides excellent local control". Clinical Cancer Research. 13 (12): 3637–3641. doi:10.1158/1078-0432.CCR-06-2095. PMID17575228. S2CID14016432.
