Altretamine is a drug from the group of cytostatics. It is used in the chemotherapy treatment of ovarian cancer. The drug is taken as a tablet in two to three week cycles. It often causes side effects such as nausea and vomiting.
What is altretamine?
Altretamine is the international name for the cytostatic substance hexamethylmelamine. The drug is used successfully in advanced ovarian cancer in the United States of America under the trade name Hexalen®.
Cytostatics disrupt the cell cycle and thus prevent the division and spread of tumor cells. Altretamine is a prodrug. This term describes the preliminary stage of a drug that is only converted into an active substance in the human organism through certain metabolic processes.
The cytostatic altretamine is metabolized in the liver to the actually active substance. Its use in cancer treatment is much more widespread in the United States than in Germany. Altretamine is only sparingly soluble and is therefore administered orally.
Pharmacological effect
Every year in Germany around 9,000 women develop a malignant tumor of the ovary. In medical terminology, this is known as ovarian carcinoma. Ovarian cancer is the second most common malignant tumor of the female genital area, which in many cases even leads to death.
The administration of altretamine disrupts important metabolic processes in the cell division of malignant tumors. The cytostatic prevents the cancer cells from dividing further and causes them to die.But like almost all cell toxins, altretamine not only affects the malignant cells, but also affects all types of tissue that regenerate quickly. This can result in unpleasant side effects, especially on the skin and the mucous membranes in the mouth, throat and digestive tract.
In addition, the attending physician must regularly monitor the cancer patient's blood count in order to detect any undesirable effects of the cytostatic on the blood-forming cells in the bone marrow in good time. The bone marrow must first regenerate before treatment with altretamine can be continued. The liver and kidney values must also be checked during the therapy phase. The treatment can cause organic damage to the liver and kidneys.
Chemotherapy considerably weakens the immune system of the affected patient. As long as altretamine is being administered, contact with people suffering from a contagious infectious disease must therefore be avoided at all costs. Vaccinations with live vaccines may also not be carried out during this phase. These can trigger the disease they are normally supposed to protect against due to the weakened immune system.
Medical application & use
The treatment cycles with altretamine last 14 to 21 days and are repeated several times. In this way, the tumor cells that are currently in a resting phase in a certain treatment cycle are also recorded. As long as there is no cell division, altretamine cannot attack the genetic material of the malignant tumor cells.
Accordingly, there are fourteen to twenty-one day breaks between the individual therapy phases. The organism needs the resting phase to regenerate the damaged tissue, which can recover much faster than the tumor tissue. The medicine destroys the malignant tumor cells and prevents the formation of metastases.
The active ingredient hexamethylmelamine has been clinically tested over a period of several years and has led to considerable success in the treatment of oval carcinomas, especially in the U.S.A. There, the effectiveness of the cytostatic in combination with other substances could be proven in various studies.
Risks & side effects
Cytostatics like altretamine often cause significant side effects. Body areas with high cell division activity are particularly affected. The intestinal mucosa is particularly affected due to its constant regeneration processes.
Patients then often suffer from stomach and intestinal complaints such as diarrhea, nausea and vomiting. Cell division also takes place in the bone marrow. There, altretamine prevents the formation of red and white blood cells. The consequences are anemia and a weakened immune system. The lack of oxygen-carrying red blood cells leads to tiredness, exhaustion and often shortness of breath.
Due to the weakened immune defense of the body, infections and inflammations are more common. Another characteristic of chemotherapy treatments with cytotoxic drugs is hair loss. The medicine prevents the cells from dividing constantly, which are necessary for hair growth. Most of the side effects depend on the dose of active ingredient given.
