# Lomustine (CCNU)

Source: https://onco.cc/drugs/lomustine/  
OnCo record `lomustine` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

An old chemotherapy pill used when glioblastoma comes back, and the control arm most new glioblastoma drugs must beat.

## Summary

Standard second-line agent in Europe and the control in EORTC 26101 (lomustine ± bevacizumab), REGOMA, and most recurrent-glioblastoma trials; median OS ~8-9 months at recurrence. CeTeG/NOA-09 suggested lomustine-temozolomide improves OS in MGMT-methylated newly diagnosed disease. Delayed, cumulative myelosuppression limits cycles.

## Fields

- Kind: Treatment
- Status: standard-of-care
- Last checked: 2026-09-06
- Brand: Gleostine
- Modality: Oral nitrosourea chemotherapy
- Mechanism: Lipophilic nitrosourea; DNA alkylation and crosslinking; crosses the blood-brain barrier.
- Approvals: US 1976: Brain tumours after surgery/radiation; Hodgkin lymphoma

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Lomustine
- Wikipedia: https://en.wikipedia.org/wiki/Lomustine

## Connected records

- cancers: [Astrocytoma, IDH-mutant (grades 2 to 4)](https://onco.cc/cancers/idh-mutant-astrocytoma/), [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/), [Group 3 and group 4 medulloblastoma (non-WNT/non-SHH)](https://onco.cc/cancers/medulloblastoma-group-3-4/), [Medulloblastoma](https://onco.cc/cancers/medulloblastoma/), [Oligodendroglioma, IDH-mutant and 1p/19q-codeleted](https://onco.cc/cancers/oligodendroglioma/), [SHH-activated medulloblastoma](https://onco.cc/cancers/medulloblastoma-shh/), [WNT-activated medulloblastoma](https://onco.cc/cancers/medulloblastoma-wnt/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Fertility in girls and young women treated for cancer, including ovarian tissue freezing](https://onco.cc/technologies/rejuv-paed-fertility-female/)
- companies: [NextSource Biotechnology](https://onco.cc/companies/nextsource-biotechnology/)
- terms: [Blood-brain barrier (BBB)](https://onco.cc/terms/blood-brain-barrier/)
- trials: [A Study of Berubicin in Adult Subjects With Recurrent Glioblastoma Multiforme](https://onco.cc/trials/nct04762069/), [A Study of Treatment for Medulloblastoma Using Sodium Thiosulfate to Reduce Hearing Loss](https://onco.cc/trials/nct05382338/), [ACNS1422](https://onco.cc/trials/acns1422/), [Actuate 1801 Part 3B (elraglusib)](https://onco.cc/trials/actuate-1801/), [CODEL](https://onco.cc/trials/codel/), [COG ACNS0331](https://onco.cc/trials/acns0331/), [EORTC 26951](https://onco.cc/trials/eortc-26951/), [GBM AGILE](https://onco.cc/trials/gbm-agile/), [RTOG 9402](https://onco.cc/trials/rtog-9402/), [Surgery, Radiation Therapy, and Chemotherapy With or Without Photodynamic Therapy in Treating Patients With Newly Diagnosed or Recurrent Malignant Supratentorial Gliomas](https://onco.cc/trials/nct00003788/)
- people: [Michael Weller](https://onco.cc/people/michael-weller/)
- drugs: [Mebendazole](https://onco.cc/drugs/mebendazole/), [Procarbazine](https://onco.cc/drugs/procarbazine/)
- key papers: [Reverse swing-M, phase 1 study of repurposing mebendazole in recurrent high-grade glioma](https://onco.cc/key-papers/paper-patil-mebendazole-glioma-phase-1-cancer-med-2020/)
- pathways: [Base excision repair, PARP & alkylation damage](https://onco.cc/pathways/base-excision-repair-parp/), [Glioma (KEGG map)](https://onco.cc/pathways/glioma-signalling/), [The blood-brain barrier & brain metastasis](https://onco.cc/pathways/blood-brain-barrier-metastasis/)

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JSON: https://onco.cc/api/v1/entities/lomustine.json