Vinca Alkaloids
This group includes vincristine, vinblastine and vinorelbine.
Mechanism of Action
These drugs act on microtubules, essential for cell division. They cause depolymerisation of the microtubules and M phase arrest. They are radiation sensitisers due to the impact on M phase as well as on DNA repair.
Side Effects
Side effects are drug specific:
- Vincristine has potent peripheral neuropathic effects and this is dose limiting. Other effects, including myelosuppression, are mild.
- Vinblastine has fewer neuropathic effects but does cause significant myelosuppression.
- Vinorelbine is perhaps the mildest of the three, but still causes myelosuppression.
Uses
Vinorelbine is used for lung cancer, often in combination with a platinum agent (eg. cisplatin/vinorelbine). Vinblastine is widely used in haematological malignancies, including Hodgkin's lymphoma (ABVD) and non-Hodgkin's lymphoma. Vincristine, often marketed as Oncovin, typically stands for the 'O' in many treatment regiments, including CHOP and BEACOPP.
