dacarbazine

Dacarbazine, sold under brand names such as DTIC-Dome, is a chemotherapy agent used in cancer treatment. It is an alkylating agent of the triazine class and is administered intravenously. Dacarbazine is a prodrug that is rapidly activated in the body to MTIC (5-diazoimidazole-4-carboxamide), which then decomposes to a reactive methyl diazonium ion that methylates DNA, producing cytotoxic damage in dividing cells.

Mechanism of action: The methylating species produced from MTIC primarily targets DNA bases, notably at the O6-guanine and N7-guanine positions, leading to mispairing, strand breaks, and cell death in rapidly proliferating cells. This results in antineoplastic effects but also contributes to the drug’s toxicity profile.

Clinical use: Dacarbazine has been used most notably for metastatic malignant melanoma and has appeared in regimens for Hodgkin lymphoma, soft tissue sarcoma, and neuroblastoma. Its role today is frequently as part of combination chemotherapy, and monotherapy is less common in many settings due to toxicity and the availability of newer therapies.

Safety and administration: Dacarbazine is given by intravenous infusion, typically in cycles every 3 to 4 weeks. Common adverse effects include nausea and vomiting, fatigue, and bone marrow suppression (neutropenia, thrombocytopenia), as well as hepatotoxicity, mucositis, and alopecia. Hypersensitivity or infusion reactions can occur; caution is advised in hepatic impairment and during pregnancy. Brand names include DTIC-Dome.