Altretamine is a drug from the group of cytostatic drugs. It is used for the chemotherapeutic 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 a drug in a group called cytostatics. It is used for the chemotherapeutic treatment of ovarian cancer. Altretamine is the common international name for the cytostatic drug hexamethylmelamine. The drug is successfully used in the United States of America under the trade name Hexalen for advanced-stage ovarian cancer. Cytostatic drugs disrupt the cell cycle and thus prevent the division and spread of tumor cells. Altretamine is a prodrug. This term refers to the precursor of a drug that is only transformed into the active substance in the human organism by certain metabolic processes. The cytostatic drug altretamine is metabolized in the liver to the actual active substance. Its use for cancer treatment is much more widespread in the United States of America than in Germany. Altretamine is only slightly soluble and is therefore administered orally.
Pharmacologic action
Every year, about 9,000 women in Germany develop a malignant tumor of the ovary. This is referred to in medical terminology as ovarian carcinoma. Ovarian carcinoma is considered 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 the malignant tumors. The cytostatic prevents further division of the cancer cells and causes them to die. However, like almost all cytotoxins, Altretamine not only affects the malignant cells, but also impairs all types of tissue that regenerate quickly. Thus, unpleasant side effects can occur especially on the skin as well as 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 drug 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. Liver and kidney values must also be monitored during the therapy phase. The treatment can cause organic damage to the liver and kidneys. Chemotherapy considerably weakens the immune system of the affected patients. Therefore, as long as Altretamine is administered, contact with persons suffering from a contagious infectious disease must be avoided at all costs. Vaccinations with live vaccines must also not be administered during this phase. These can cause the disease they are normally intended to protect against to break out due to the weakened immune system.
Medical application and use
Treatment cycles with altretamine last 14 to 21 days and are repeated several times. This also captures tumor cells that are currently dormant during a given treatment cycle. As long as no cell division takes place, Altretamine cannot attack the genetic material of the malignant tumor cells. Accordingly, there are breaks of fourteen to twenty-one days 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 drug 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 ovarian carcinoma, particularly in the U.S.A.. There, the efficacy of the cytostatic agent in combination with other substances has been demonstrated in various studies.
Risks and side effects
Cytostatic drugs such as altretamine often cause significant side effects. Areas of the body with high cell division activity are particularly affected. The intestinal mucosa is particularly affected due to its constant regenerative processes. Patients then frequently suffer from gastrointestinal complaints such as diarrhea, nausea and vomiting. Cell division is also active in the bone marrow. There, altretamine impedes 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 fatigue, exhaustion and often also to shortness of breath. Due to the body’s weakened immune defenses, infections and inflammations occur more frequently. Another characteristic of chemotherapeutic treatments with cytostatics is hair loss. The drug impedes the cell divisions that are constantly required for hair growth. Most side effects depend on the dose of drug administered.