organisation [2000:<25,000 50% Alternatively, to avoid potential overdosage associated with manufacturer s suggested modifications, some clinicians recommend reducing subsequent dosage by 25% when platelet nadirs are 50,000 74,999/mm 3 ; by 50% for nadirs of 25,000 49,999/mm 3 ; and by 75% for nadirs> <25,000/mm 3 . d Prescribing Limits Adults Brain Tumors Intracranial Wafer Implant Maximum 8 wafers per surgical procedure. 124 Special Populations Geriatric Patients Select IV dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy. 105 148 (See Geriatric Use under Cautions.) Cautions for Carmustine Contraindications Known hypersensitivity to carmustine or any ingredient in the formulations. 105 124 Warnings/Precautions Warnings Hematologic Effects Risk of myelosuppression (e.g., thrombocytopenia, leukopenia) following IV carmustine; effects are delayed and cumulative. 105 (See Boxed Warning.) Thrombocytopenia generally more severe than leukopenia but both considered dose-limiting toxicities. 105 Anemia reported less frequently and is less severe. 105 Following IV administration, thrombocytopenia and leukopenia occur at approximately 4 and 5 6 weeks, respectively, and persist for 1 2 weeks. 105 Repeated dosing associated with more severe and more prolonged myelosuppression. 105 Use with caution in patients with depressed platelet, leukocyte, or erythrocyte counts. d Pulmonary Effects With IV carmustine, risk of dose-related, sometimes fatal, pulmonary toxicity (characterized by pulmonary infiltrates and/or fibrosis). 105 (See Boxed Warning.) Risk factors include prolonged therapy (with cumulative doses> 1400 mg/m 2 ) and history of lung disease. 105 Risk of delayed-onset pulmonary fibrosis (occurred up to 17 years after treatment during childhood and early adolescence); possible reduction of pulmonary function or death. 105 (See Pediatric Use under Cautions.) Perform pulmonary function tests prior to initiation of and frequently during therapy. 105 Patients with baseline forced vital capacity (FVC) or pulmonary diffusion capacity for carbon monoxide (DL CO ) <70% of predicted value are particularly at risk. 105 Secondary Malignancies Risk of secondary malignancies following long-term use of nitrosoureas. 105 Intracranial Implant Complications Intracerebral mass effect unresponsive to corticosteroids reported, including one case leading to brain herniation. 124 Brain edema with mass effect (due to tumor recurrence, intracranial infection, or necrosis) may necessitate reoperation and, in some cases, removal of wafer or wafer remnants. 124 Risk of seizures; median time to onset is 3.5 days. 124 Formation of tumor bed cyst unresponsive to high-dose corticosteroids reported; required reoperation for drainage following implantation of carmustine wafers. 136 Monitor patients closely for potential complications of craniotomy (e.g., seizures, intracranial infections, abnormal wound healing, brain edema). 124 Fetal/Neonatal Morbidity and Mortality Possible fetal harm; teratogenicity and embryotoxicity demonstrated in animals. 105 Avoid pregnancy during therapy. 105 If used during pregnancy or if patient becomes pregnant, apprise of potential fetal hazard. 105 124 Major Toxicities Local Effects Rapid IV infusion may result in intensive flushing of the skin and suffusion of the conjunctiva; these effects occur within 2 hours and persist for 4 hours after IV administration. 105 Also associated with intense pain and burning at injection site; thrombosis is rare. 105 With intracranial wafer implant, wound dehiscence; delayed wound healing; subdural, subgaleal, or wound effusions; and CSF leak reported. 124 Infectious Complications With intracranial wafer implant, abscess, meningitis, and pneumonia reported. 124 Sepsis reported but causal relationship not established. 124 GI Effects With IV carmustine, dose-related nausea and vomiting reported within 2 hours and persisting for 4 6 hours. 105 Premedication with antiemetics may diminish or prevent. 105 Hepatic Effects After IV therapy, reversible increases in serum transaminase, alkaline phosphatase, and bilirubin concentrations reported. 105 Possible hepatic dysfunction. 105 Monitor hepatic function periodically. 105 Renal Effects After prolonged IV therapy (with large cumulative doses), progressive azotemia, decrease in kidney size, and renal failure reported. 105 Kidney damage reported occasionally in patients receiving lower total doses. 105 Monitor renal function periodically. 105 General Precautions IV Therapy Evaluate carmustine benefits against possible risks. 105 Most adverse effects are reversible if detected early with appropriate management (e.g., dosage reduction, discontinuance, appropriate corrective measures). 105 Reinstitute with caution, considering risks and benefits. 105 Risk of transient hyperpigmentation of skin with accidental dermal exposure; immediately wash exposed skin or mucosa. 105 Intracranial Wafer Implant Risk of wafer migration from surgical resection cavity into ventricular system, leading to obstructive hydrocephalus. 124 If communication between surgical resection cavity and ventricular system is larger than diameter of wafers, close such communication prior to implantation. 124 Enhancement in brain tissue surrounding resection cavity (demonstrated by CT scan or MRI) following intracranial implantation may represent edema and inflammation caused by wafer or tumor progression. 124 Therapy Monitoring With IV therapy, monitor CBCs weekly during and for at least 6 weeks following each dose. 105 Also monitor pulmonary, hepatic, and renal function tests periodically during treatment. 105 Specific Populations Pregnancy Category D. 105 124 (See Fetal/Neonatal Morbidity and Mortality under Cautions.) Lactation Not known whether carmustine is distributed into milk. 105 124 Discontinue nursing because of potential risk to nursing infants. 105 124 Not known whether constituents of polifeprosan 20 copolymer (i.e., carboxyphenoxypropane, sebacic acid) intracranial wafer are distributed into milk. 124 Pediatric Use Safety and efficacy of IV carmustine not established in children. 105 Fatal pulmonary fibrosis reported with delayed onset up to 17 years following IV treatment of brain tumors during childhood or adolescence. 105 Extremely high risk of fatal pulmonary toxicity, particularly in children> <5 years of age at initial treatment; carefully weigh benefits and risks of therapy in pediatric patients. 105 Safety and efficacy of intracranial wafer implant not established in pediatric patients. 124 Geriatric Use Insufficient experience in patients 65 years of age to determine whether geriatric patients respond differently than younger adults. 105 Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and potential for concomitant disease and drug therapy. 105 148 Systemic carmustine substantially eliminated by kidneys; monitor renal function periodically since geriatric patients are more likely to have decreased renal function. 105 148 Common Adverse Effects For IV carmustine, pulmonary infiltrates and/or fibrosis, thrombocytopenia, leukopenia, anemia, nausea, vomiting, hepatic and renal toxicity. 105 (See Warnings/Precautions under Cautions.) For intracranial wafer, hemiplegia, seizures, confusion, brain edema, headache, asthenia, nausea, vomiting, constipation, infection, fever, aphasia, abnormal healing, depression, pain, rash, somnolence, speech disorder, deep thrombophlebitis, alopecia. 124 Interactions for Carmustine Intracranial Wafer No formal drug interaction studies to date. 124 In clinical trials, chemotherapy was withheld for at least 4 weeks (6 weeks for nitrosoureas) prior to and 2 weeks after surgery. 124 Implantation in conjunction with radiotherapy does not appear to have any short-term or chronic toxicities; 124 in clinical trials, external beam radiation therapy was administered> 3 weeks after surgery. 124 Specific Drugs Drug Interaction Comments Cimetidine Potentiation of neutropenic and thrombocytopenic effect of carmustine d Mitomycin Possible changes in tear films, with subsequent damage of corneal and conjunctival epithelium 146 Phenytoin Possible decreased serum phenytoin concentrations 147 Monitor serum phenytoin concentrations carefully and adjust dosage accordingly 147 Carmustine Pharmacokinetics Absorption Bioavailability Intracranial wafer: Plasma concentrations following intracranial implantation not determined in humans; not detectable in plasma of rabbits undergoing surgical implantation of 3.85% carmustine wafers. 124 Absorption of biodegradable copolymer from wafers has not been evaluated in humans. 124 Distribution Extent Readily crosses the blood-brain barrier (due to high lipid solubility); concentrations of radioactivity in CSF are 50% of concurrent plasma concentrations. 105 Not known whether carmustine is distributed into milk. 105 124 Intracranial wafer: Concentration achieved in brain tissue not determined. 124 Not detectable in CSF of rabbits undergoing surgical implantation of 3.85% carmustine wafers. 124 Distribution of biodegradable copolymer from wafers has not been evaluated in humans. 124 Elimination Metabolism Rapidly metabolized and cleared from plasma following IV administration; no intact drug detectable after 15 minutes. 105 Antineoplastic and toxic effects believed to be caused by active metabolites. 105 Intracranial wafer: Carmustine is released and diffuses into brain tissue after hydrolysis of anhydride bonds in implant copolymer. 124 Metabolism of copolymer not evaluated in humans; 2 monomers (carboxyphenoxypropane and sebacic acid) are released. 124 Elimination Route Excreted principally in urine as metabolites. 105 Following IV administration, about 30 or 60 70% of radioactivity excreted within 24 38 or 96 hours, respectively. 105 124 About 6 10% of radioactivity excreted as respiratory carbon dioxide. 105 124 Intracranial wafer: Biodegradable in human brain. 124 In animal studies, >70% of polifeprosan 20 copolymer degrades into monomers within 3 weeks of implantation. 124 Carboxyphenoxypropane is eliminated renally; sebacic acid is metabolized in liver and expired as carbon dioxide. 124 Half-life 22 minutes following IV infusion. 124 In humans, wafer remnants have been observed on brain imaging scans or located during subsequent surgical procedures up to 8 months following intracranial implantation. 124 Wafer remnants retrieved from 2 patients approximately 2 3 months after implantation consisted mostly of water and monomers with minimal carmustine. 124 Stability Storage Parenteral Powder for Injection 2 8 C; discard after 3 years. 105 Lyophilized powder decomposes to an oily liquid at temperatures 30.5 C. 105 Upon receipt, inspect vials that may not have been refrigerated adequately by holding them up to bright light. 105 Discard if an oily film is present. 105 If dry flakes or a dry, congealed mass is present, vial is suitable for use; refrigerate immediately. 105 Store reconstituted solution in glass container at 25 C; protect from light. 101 105 Discard after 8 hours. 105 Store diluted solution in glass container at 25 C; protect from light. 105 Discard after 8 hours. 105 Intracranial Implants -20 C. 124 Do not open aluminum foil laminate pouches containing wafer until immediately prior to implantation in the operating room. 124 May keep unopened foil pouches at ambient room temperature for up to 6 hours. 124 Compatibility For information on systemic interactions resulting from concomitant use, see Interactions. Parenteral Solution Compatibility HID Compatible for 8 hours at 25 C; 101 use within 8 hours. 105 Compatible Sodium chloride 0.9% Variable Dextrose 5% in water Drug Compatibility Admixture CompatibilityHID Incompatible Sodium bicarbonate Y-Site CompatibilityHID Compatible Amifostine Aztreonam Cefepime HCl Etoposide phosphate Filgrastim Fludarabine phosphate Gemcitabine HCl Granisetron HCl Melphalan HCl Ondansetron HCl Piperacillin sodium tazobactam sodium Sargramostim Teniposide Thiotepa Vinorelbine tartrate Incompatible Allopurinol sodium Actions Alkylates DNA and RNA. 105 124 May inhibit several key enzymatic processes by carbamoylation of amino acids in proteins. 105 Overall result is thought to be the inhibition of both DNA and RNA synthesis. d Cytotoxic effect of wafer depends on release of sufficient amounts of carmustine in the tumor cavity to achieve tumoricidal concentrations. 124 Advice to Patients Risk of myelosuppression or pulmonary toxicity with conventional chemotherapy. 105 Importance of adherence to laboratory appointment schedules. 105 Notify clinician if fever, sore throat, or unusual bleeding or bruising occurs. d Risk of post-implantation complications with wafers. 124 Importance of informing clinicians of existing or contemplated therapy, including prescription and OTC drugs and dietary or herbal supplements, as well as any concomitant illnesses. 105 124 Importance of women informing their clinician if they are or plan to become pregnant or to breast-feed. 105 124 Importance of women avoiding pregnancy during therapy. 105 124 Advise pregnant women of risk to the fetus. 105 124 Importance of informing patients of other important precautionary information. (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Carmustine Routes Dosage Forms Strengths Brand Names Manufacturer Local For injection, for IV infusion 100 mg BiCNU (with 3 mL dehydrated [absolute] alcohol diluent) Bristol-Myers Squibb Local Implants 7.7 mg (of carmustine per wafer) Gliadel Wafer (with polifeprosan 20) Guilford AHFS DI Essentials. Copyright 2017, Selected Revisions August 1, 2007. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. Use is not currently included in the labeling approved by the US Food and Drug Administration. References Only references cited for selected revisions after 1984 are available electronically. 38. Kleinman LM et al. Investigational drug information. Drug Intell Clin Pharm . 1976; 10:48-9. 100. Zackheim HS, Epstein EH Jr, McNutt NS et al. Topical carmustine (BCNU) for mycosis fungoides and related disorders. J Am Acad Dermatol . 1983; 9:363-74. [PubMed 6630597] 101. Lauper RD (Bristol-Myers Oncology, Syracuse, NY): Personal communication; 1985 Nov. 102. Benvenuto JA, Anderson RW, Kerkov K et al. Stability and compatibility of antitumor agents in glass and plastic containers. Am J Hosp Pharm . 1981; 38: 1914-8. 103. Laskar PA, Ayres JW. Degradation of carmustine in aqueous media. J Pharm Sci . 1977; 66:1073-6. [PubMed 19612] 104. Colvin M, Hartner J, Summerfield M. Stability of carmustine in the presence of sodium bicarbonate. Am J Hosp Pharm . 1980; 37:677-8. [PubMed 7386477] 105. Bristol-Myers Squibb. BiCNU (carmustine for injection) prescribing information. Princeton, NJ; 2003 Oct. 106. Patten GA, Billi JE, Rotman HH. Rapidly progressive, fatal pulmonary fibrosis induced by carmustine. JAMA . 1980; 244:687-8. [PubMed 7392168] 107. Johnson R, Douglas J, Corey L et al. Carmustine and myelodysplasia. Ann Intern Med . 1985; 103(6 Part 1):964-5. 108. Greene MH, Boice JD Jr, Strike TA. Carmustine as a cause of acute nonlymphocytic leukemia. N Engl J Med . 1985; 313:579. [PubMed 3894973] 109. Durant JR, Norgard MJ, Murad TM et al. Pulmonary toxicity associated with bischloroethylnitrosourea (BCNU). Ann Intern Med . 1979; 90:191-4. [PubMed 443651] 110. Weiss RB, Muggia FM. Pulmonary effects of carmustine (bischloroethylnitrosourea, BCNU). Ann Intern Med . 1979; 91:131-2. [PubMed 464441] 111. Sweet DL. Pulmonary effects of carmustine (bischloroethylnitrosourea, BCNU). Ann Intern Med . 1979; 91:132. [PubMed 464443] 112. Durant JR. Pulmonary effects of carmustine (bischloroethylnitrosourea, BCNU). Ann Intern Med . 1979; 91:132-3. 113. Food and Drug Administration. Prescription drug advertising; content and format for labeling of human prescription drugs. Fed Regist . 1979; 44:37434-67. 114. Melanoma. From: CancerNet/PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2001 Jun. 115. Duran Garcia E, Santolaya R, Requena T. Treatment of malignant melanoma. Ann Pharmacother . 1999; 33:730-8. [PubMed 10410188] 116. Cohen GL, Falkson CI. Current treatment options for malignant melanoma. Drugs . 1998; 55:791-9. [PubMed 9617594] 117. Rosenberg SA, Yang JC, Schwartzentruber DJ et al. Prospective randomized trial of the treatment of patients with metastatic melanoma using chemotherapy with cisplatin, dacarbazine, and tamoxifen alone or in combination with interleukin-2 and interferon alfa-2b. J Clin Oncol . 1999; 17:968-75. [PubMed 10071291] 118. Falkson CI, Ibrahim J, Kirkwood JM et al. Phase III trial of dacarbazine versus dacarbazine with interferon alpha-2b versus dacarbazine with tamoxifen versus dacarbazine with interferon alpha-2b and tamoxifen in patients with metastatic malignant melanoma: an Eastern Cooperative Oncology Group study. J Clin Oncol . 1998; 16:1743-51. [PubMed 9586887] 119. Margolin KA, Liu PY, Flaherty LE et al. Phase II study of carmustine, dacarbazine, cisplatin, and tamoxifen in advanced melanoma: a Southwest Oncology Group study. J Clin Oncol . 1998; 16:664-9. [PubMed 9469356] 120. Anon. Drugs of choice for cancer. Treat Guidel Med Lett . 2003; 1:41-52. [PubMed 15529105] 121. Chapman PB, Einhorn LH, Meyers ML et al. Phase III multicenter randomized trial of the Dartmouth regimen versus dacarbazine in patients with metastatic melanoma. J Clin Oncol . 1999; 17:2745-51. [PubMed 10561349] 122. Reviewers comments (personal observations) on melanoma. 123. Mycosis fungoides and the Sezary syndrome. From: CancerNet/PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2001 Sep. 124. Guilford Pharmaceuticals Inc. Gliadel wafer (polifeprosan 20 with carmustine implant) prescribing information. Baltimore, MD; 2003 Feb. 125. DeAngelis LM. Brain tumors. N Engl J Med . 2001; 344:114-23. [PubMed 11150363] 126. Walker MD, Alexander E Jr, Hunt WE et al. Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg . 1978; 49:333-43. [PubMed 355604] 127. Walker MD, Green SB, Byar DP et al. Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med . 1980; 303:1323-9. [PubMed 7001230] 128. Cairncross JG, Macdonald DR. Successful chemotherapy for recurrent malignant oligodendroglioma. Ann Neurol . 1988; 23:360-4. [PubMed 3382171] 129. Galanis E, Buckner J. Chemotherapy for high-grade gliomas. Br J Cancer . 2000; 82:1371-80. [PubMed 10780513] 130. Fine HA, Dear KB, Loeffler JS et al. Meta-analysis of radiation therapy with and without adjuvant chemotherapy for malignant gliomas in adults. Cancer . 1993; 71:2585-97. [PubMed 8453582] 131. Medical Research Council. Randomized trial of procarbazine, lomustine, and vincristine in the adjuvant treatment of high-grade astrocytoma: a Medical Research Council trial. J Clin Oncol . 2001; 19:509-18. [PubMed 11208845] 132. Shapiro WR. Chemotherapy of malignant gliomas: studies of the BTCG. Rev Neurol (Paris) . 1992; 148:428-34. [PubMed 1448662] 133. Brem H, Piantadosi S, Burger PC et al. Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. Lancet . 1995; 345:1008-12. [PubMed 7723496] 134. Valtonen S, Timonen U, Toivanen P et al. Interstitial chemotherapy with carmustine-loaded polymers for high-grade gliomas: a randomized double-blind study. Neurosurgery . 1997; 41:44-8; discussion 48-9. [PubMed 9218294] 135. Adult brain tumors. From PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2005 Mar 24. 136. Engelhard HH. Tumor bed cyst formation after BCNU wafer implantation: report of two cases. Surg Neurol . 2000; 53:220-4. [PubMed 10773252] 137. Anon. Gliadel wafers for treatment of brain tumors. Med Lett Drugs Ther . 1998; 40:92. [PubMed 9760950] 138. Multiple myeloma and other plasma cell neoplasms. From: CancerNet/PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2001 Oct. 139. Myeloma Trialists Collaborative Group. Combination chemotherapy versus melphalan plus prednisone as treatment for multiple myeloma: an overview of 6,633 patients from 27 randomized trials. J Clin Oncol . 1998; 16:3832-42. [PubMed 9850028] 140. Mineur P, Menard JF, Le Loet X et al. VAD or VMBCP in multiple myeloma refractory to or relapsing after cyclophosphamide-prednisone therapy (protocol MY 85). Br J Haematol. 1998;103:512-7. 141. Adult Hodgkin s disease. From: CancerNet/PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2001 Sep. 142. Chopra R, McMillan AK, Linch DC et al. The place of high-dose BEAM therapy and autologous bone marrow transplantation in poor-risk Hodgkin s disease. A single-center eight-year study of 155 patients. Blood . 1993; 81:1137-45. [PubMed 8443375] 143. Nademanee A, O apos;Donnell MR, Snyder DS et al. High-dose chemotherapy with or without total body irradiation followed by autologous bone marrow and/or peripheral blood stem cell transplantation for patients with relapsed and refractory Hodgkin s disease: results in 85 patients with analysis of prognostic factors. Blood . 1995; 85:1381-90. [PubMed 7858268] 144. Adult non-Hodgkin s lymphoma. From: CancerNet/PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2001 Oct. 145. Mills W, Chopra R, McMillan A et al. BEAM chemotherapy and autologous bone marrow transplantation for patients with relapsed or refractory non-Hodgkin s lymphoma. J Clin Oncol . 1995; 13:588-95. [PubMed 7884420] 146. Cruciani F, Tamanti N, Abdolrahimzadeh S et al. Ocular toxicity of systemic chemotherapy with megadoses of carmustine and mitomycin. Ann Ophthalmol . 1994; 26:97-100. [PubMed 7944163] 147. Grossman SA, Sheidler VR, Gilbert MR. Decreased phenytoin levels in patients receiving chemotherapy. Am J Med . 1989; 87:505-10. [PubMed 2683764] 148. Food and Drug Administration. MedWatch Safety-related drug labeling changes: BiCNU (carmustine) [February 2003]. From FDA web site . 149. Zackheim HS, Epstein EH Jr, Crain WR. Topical carmustine (BCNU) for cutaneous T cell lymphoma: a 15-year experience in 143 patients. J Am Acad Dermatol . 1990; 22:802-10. [PubMed 2347966] 150. Zackheim HS. Topical carmustine (BCNU) in the treatment of mycosis fungoides. Dermatol Ther . 2003; 16:299-302. [PubMed 14686972] 151. Guilford Pharmaceuticals Inc. Gliadel wafer (polifeprosan 20 with carmustine implant) prescribing information. Baltimore, MD; 2000 Aug. c. Adult brain tumors. From: PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2006 Apr 6. d. AHFS drug information 2003. McEvoy GK, ed. Carmustine. Bethesda, MD: American Society of Health-System Pharmacists; 2003:919-23. HID. Trissel LA. Handbook on injectable drugs. 14th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2007:263-6. Next Interactions Print this page Add to My Med List More about carmustine Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 0 Reviews Add your own review/rating Drug class: alkylating agents Consumer resources Carmustine ... +4 more Professional resources Carmustine (Wolters Kluwer) Other brands: Gliadel , BiCNU Related treatment guides Brain Tumor Glioblastoma Multiforme Hodgkin's Lymphoma Malignant Glioma Multiple Myeloma Non-Hodgkin's Lymphoma ]} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only D Pregnancy Category Positive evidence of risk N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Alkylating agents Related Drugs Hodgkin's Lymphoma Opdivo , Keytruda , cyclophosphamide , nivolumab , Cytoxan , etoposide , More... Non-Hodgkin's Lymphoma methotrexate , Rituxan , rituximab , cyclophosphamide , Imbruvica , Cytoxan , More... Glioblastoma Multiforme Avastin , bevacizumab , Temodar , temozolomide , Gliadel , Matulane , More... Brain Tumor cisplatin , lomustine , Gliadel , Platinol , Gleostine , BiCNU , More... 2 more conditions... Carmustine Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first!} } expect
tail lamps Carmustine all people
EmoticonEmoticon