vinblastine
Summary
Vinblastine is a vinca alkaloid antineoplastic that binds beta-tubulin and prevents microtubule polymerization, arresting cells in M phase. Used in Hodgkin lymphoma (the 'V' in ABVD) and testicular cancer; key toxicity is bone marrow suppression.
Detail
Vinca alkaloids (vinblastine, vincristine, vinorelbine) are derived from Catharanthus roseus (periwinkle). They bind beta-tubulin at a site distinct from taxanes and block microtubule assembly, preventing mitotic spindle formation and causing M-phase arrest. Vinblastine is part of ABVD for Hodgkin lymphoma (Adriamycin/doxorubicin, Bleomycin, Vinblastine, Dacarbazine) and is also used for testicular cancer and Kaposi sarcoma. Mnemonic for toxicities: vinBLASTine BLASTs the bone marrow (myelosuppression is dose-limiting), whereas vinCRISTine CRISPs the nerves (peripheral neuropathy is dose-limiting; relatively marrow-sparing). Both can cause SIADH and constipation/ileus. Resistance mechanism: MDR1/P-glycoprotein efflux.
Sources
- First Aid for USMLE Step 1 2024
- Sketchy Pharm
- Katzung Basic & Clinical Pharmacology
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