CeeNU

CeeNU is the brand name for lomustine, a nitrosourea alkylating chemotherapy agent used to treat certain cancers. It is administered orally as capsules and is typically prescribed for brain tumors, among other indications.

Lomustine works by alkylating DNA, forming cross-links that disrupt DNA replication and lead to cancer cell death. Its lipophilic nature allows it to cross the blood-brain barrier, making it useful for central nervous system tumors. Dosing is given intermittently, usually every six weeks, and the exact amount is determined by body surface area and clinical factors.

Indications for lomustine include treatment of newly diagnosed or recurrent glioblastoma multiforme and anaplastic astrocytoma. It is also used as part of the PCV chemotherapy regimen—comprising procarbazine, lomustine (CeeNU), and vincristine—for certain oligodendroglial tumors.

Administration and monitoring considerations include baseline and periodic complete blood counts and liver function tests due to potential bone marrow suppression and hepatotoxicity. Contraindications include significant bone marrow suppression, severe hepatic impairment, and pregnancy. Women of childbearing potential and men should use effective contraception during treatment and for a period after completion. Caution is advised with concurrent myelosuppressive therapies and vaccinations.

Common adverse effects are bone marrow suppression (neutropenia and thrombocytopenia), nausea, vomiting, fatigue, and elevated liver enzymes. Lomustine can also cause pulmonary toxicity, hepatic injury with cumulative exposure, and increased infection risk. Patients receiving CeeNU require careful monitoring and follow-up to manage toxicities and adjust dosing as needed.