Streptozocin

What it is and how it works

Streptozocin is a glucosamine-linked nitrosourea that alkylates DNA and inhibits DNA synthesis. Its glucose moiety leads to selective uptake by pancreatic beta cells via the GLUT2 transporter, explaining its activity in pancreatic neuroendocrine tumours and its diabetogenic potential.

Indications

Advanced or metastatic, progressive pancreatic neuroendocrine tumours, usually in combination with 5-fluorouracil or doxorubicin.

Dosage and administration (summary)

Dosing is by specialist oncology protocol, given by intravenous infusion; common regimens are 500 mg/m² daily for 5 days every 6 weeks, or 1 g/m² weekly, adjusted to renal function and tolerance.

Contraindications

Severe renal impairment and hypersensitivity to streptozocin.

Warnings and precautions

Nephrotoxicity is dose-related and cumulative and may be severe; monitor renal function, proteinuria and electrolytes before each dose and ensure adequate hydration. Severe nausea and vomiting, myelosuppression, hepatotoxicity and glucose disturbances may occur; it is a vesicant and potential carcinogen, so avoid extravasation.

Pregnancy

Avoid in pregnancy because of potential fetal harm; effective contraception is required.

Storage and supply

Store unopened vials at 2–8 °C, protected from light; handle as a cytotoxic drug.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.