From the Periwinkle Plant to Hodgkin’s Lymphoma: Vinca Alkaloids as Nature’s Answer to Chemotherapy

Taj Dearob

Taj Dearob Pharmaceuticals offers an array of cytotoxic drugs from natural origins, such as Taxanes Paclitaxel and Docetaxel, as well as the antibiotics Bleomycin and Doxorubicin. The vinca alkaloids vinblastine and vincristine are another huge asset in the area of cancer therapies offered by Taj Accura.

Their backbone was discovered following isolation of alkaloids from the pink periwinkle plant and following experimentation for their potential multiple uses like as a hypoglycaemic^[1], they have become most widely recognised in the treatment of leukaemia, solid tumour growth as well as lymphoma, namely Hodgkin’s.

Vinca alkaloids act by interfering with microtubule assembly, which is vital to cytoskeletal structure, and thus prevents cell division and prevents cell division which is vital to chemotherapy’s role in cancer care. In the highly cited investigative article into their mechanism of action, it was discovered that each of the vinca alkaloids poses a differential action on microtubule interference^[2], which allows for scope in selecting the optimal choice of anti-tumour therapy.

Vinblastine plays a key role in ABVD chemotherapy, the first line choice in the treatment of newly diagnosed Hodgkin’s lymphoma, which is also comprised of Doxorubicin, Bleomycin and Dacarbazine^[3]. This generally requires several courses of 15 day cycles of treatment over a short period of time which can be completed on a day patient basis. This is often favoured over the more complex BEACOPP or MOPP/ABV regimens due to a lower total cost of drugs, less complicated dosage regimen, lower risk of contamination during reformulation and a lower probability of adverse reaction due to the lack of need of corticosteroid/antihistamine therapy during the regimen. On the contrary, vincristine is indicated in the CHOP regimen of treatment for non-Hodgkin’s lymphoma alongside Doxorubicin, Cyclophosphamide and Prednisolone. A New England Journal of Medicine study^[4] also warrants the inclusion of Rituximab into the CHOP regimen in large B cell lymphoma, which was reported to reduce patient CHOP treatment failure rates, as well as a reduction in patient deaths without intolerable toxicity.

Taj Dearob Pharmaceuticals offer parenteral formulations of the vinca alkaloids Vinblastine and Vincristine to a global healthcare market, from hospital emergency supply to non-governmental (NGO) tenders. Vinblastine is available as a 1mg or 10mg / ml vial formulation, and vincristine is available in either a 1 mg or 5 mg / ml vial formulation. Applicable and up-to-date clinical guidelines are recommended for guidance on dosage, as this is often dependent on varying patient factors as well as modern clinical studies.

^[1] Moudi M, Go R, Yien CYS, Nazre M. Vinca Alkaloids. International Journal of Preventive Medicine 2013;4(11):1231-1235.

^[2] Jordan, M. A., Thrower, D., & Wilson, L. (1991). Mechanism of inhibition of cell proliferation by Vinca alkaloids. Cancer Research, 51(8), 2212-2222.

^[3] Dominguez, A. R., Marquez, A., Guma, J., Llanos, M., Herrero, J., de Las Nieves, M. A., … & Alba, E. (2004). Treatment of stage I and II Hodgkin’s lymphoma with ABVD chemotherapy: results after 7 years of a prospective study. Annals of Oncology, 15(12), 1798-1804.

^[4] Coiffier, B., Lepage, E., Briere, J., Herbrecht, R., Tilly, H., Bouabdallah, R., … & Gisselbrecht, C. (2002). CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. New England Journal of Medicine, 346(4), 235-242.