# Vincristine

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

## TL;DR

A plant-derived chemotherapy from the Madagascar periwinkle that has been in almost every childhood leukaemia and lymphoma regimen since the 1960s.

## Summary

Approved 1963. Component of CHOP, ABVD-era regimens, ALL induction/maintenance, VAC/VDC (rhabdomyosarcoma, Ewing), Wilms tumour (VA/DD-4A), neuroblastoma and medulloblastoma regimens, EMA-CO. Fatal if given intrathecally; vincristine shortages (2019) disrupted paediatric care. Liposomal vincristine (Marqibo, 2012) for Ph-negative ALL was discontinued 2022.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-08
- Tags: gap-fill; generic; who-essential
- Brand: Oncovin / Marqibo
- Modality: Vinca alkaloid (microtubule inhibitor)
- Mechanism: Binds β-tubulin and prevents microtubule polymerisation, arresting mitosis; dose-limited by peripheral neuropathy.
- Approvals: US 1963: Acute leukaemia; Hodgkin and non-Hodgkin lymphoma, rhabdomyosarcoma, neuroblastoma, Wilms tumour

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Vincristine
- Label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=vincristine

## Connected records

- cancers: [Acute lymphoblastic leukaemia](https://onco.cc/cancers/all-leukemia/), [Adolescent and young adult cancers (ages 15 to 39)](https://onco.cc/cancers/aya-cancers/), [Adult T-cell leukaemia/lymphoma](https://onco.cc/cancers/adult-t-cell-leukaemia-lymphoma/), [Advanced-stage classical Hodgkin lymphoma (stage III to IV)](https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/), [Astrocytoma, IDH-mutant (grades 2 to 4)](https://onco.cc/cancers/idh-mutant-astrocytoma/), [Atypical teratoid/rhabdoid tumour (ATRT)](https://onco.cc/cancers/atrt/), [Burkitt lymphoma](https://onco.cc/cancers/burkitt-lymphoma/), [Childhood cancers (all types)](https://onco.cc/cancers/childhood-cancers/), [Childhood lung and airway tumours (pleuropulmonary blastoma, tracheobronchial tumours)](https://onco.cc/cancers/pleuropulmonary-blastoma/), [Desmoplastic small round cell tumour](https://onco.cc/cancers/desmoplastic-small-round-cell-tumour/), [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Ependymoma](https://onco.cc/cancers/ependymoma/), [Ewing sarcoma](https://onco.cc/cancers/ewing-sarcoma/), [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/), [Gestational trophoblastic neoplasia](https://onco.cc/cancers/gestational-trophoblastic/), [Group 3 and group 4 medulloblastoma (non-WNT/non-SHH)](https://onco.cc/cancers/medulloblastoma-group-3-4/), [Hepatoblastoma](https://onco.cc/cancers/hepatoblastoma/), [High-risk acute lymphoblastic leukaemia in children (high-risk B-ALL and T-ALL)](https://onco.cc/cancers/all-paediatric-high-risk/), [High-risk gestational trophoblastic neoplasia (FIGO score 7 or more, including ultra-high-risk)](https://onco.cc/cancers/high-risk-gtn/), [High-risk neuroblastoma](https://onco.cc/cancers/neuroblastoma-high-risk/), [HIV-associated (AIDS-related) lymphomas](https://onco.cc/cancers/hiv-associated-lymphoma/), [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/), [Infant acute lymphoblastic leukaemia (KMT2A-rearranged, under one year)](https://onco.cc/cancers/all-infant/), [Kaposi sarcoma](https://onco.cc/cancers/kaposi-sarcoma/), [Low-risk gestational trophoblastic neoplasia (FIGO score 0 to 6)](https://onco.cc/cancers/low-risk-gtn/), [Medulloblastoma](https://onco.cc/cancers/medulloblastoma/), [Metastatic pheochromocytoma and paraganglioma](https://onco.cc/cancers/metastatic-ppgl/), [Monomorphic epitheliotropic intestinal T-cell lymphoma](https://onco.cc/cancers/monomorphic-epitheliotropic-intestinal-t-cell-lymphoma/), [Neuroblastoma (paediatric)](https://onco.cc/cancers/neuroblastoma/), [Nodal T-follicular helper cell lymphoma, angioimmunoblastic type (angioimmunoblastic T-cell lymphoma)](https://onco.cc/cancers/angioimmunoblastic-t-cell-lymphoma/), [Nodular lymphocyte-predominant Hodgkin lymphoma (nodular lymphocyte-predominant B-cell lymphoma)](https://onco.cc/cancers/nodular-lymphocyte-predominant-hodgkin-lymphoma/), [Oligodendroglioma, IDH-mutant and 1p/19q-codeleted](https://onco.cc/cancers/oligodendroglioma/), [Optic pathway glioma](https://onco.cc/cancers/optic-pathway-glioma/), [Paediatric low-grade glioma](https://onco.cc/cancers/paediatric-low-grade-glioma/), [Pancreatoblastoma](https://onco.cc/cancers/pancreatoblastoma/), [Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)](https://onco.cc/cancers/peripheral-t-cell-lymphoma/), [Pheochromocytoma and paraganglioma (PPGL)](https://onco.cc/cancers/pheochromocytoma-paraganglioma/), [Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL)](https://onco.cc/cancers/all-paediatric-ph-positive/), [Pineoblastoma](https://onco.cc/cancers/pineoblastoma/), [Pleuropulmonary blastoma (types I, Ir, II and III)](https://onco.cc/cancers/pleuropulmonary-blastoma-dicer1/), [Post-transplant lymphoproliferative disorder (PTLD)](https://onco.cc/cancers/post-transplant-lymphoproliferative-disorder/), [Primary large B-cell lymphoma of the testis](https://onco.cc/cancers/primary-testicular-lymphoma/), [Primary mediastinal (thymic) large B-cell lymphoma](https://onco.cc/cancers/primary-mediastinal-b-cell-lymphoma/), [Relapsed and refractory acute lymphoblastic leukaemia in children](https://onco.cc/cancers/all-paediatric-relapsed/), [Retinoblastoma](https://onco.cc/cancers/retinoblastoma/), [Rhabdomyosarcoma](https://onco.cc/cancers/rhabdomyosarcoma/), [SHH-activated medulloblastoma](https://onco.cc/cancers/medulloblastoma-shh/), [Standard-risk B-cell acute lymphoblastic leukaemia in children](https://onco.cc/cancers/all-paediatric-standard-risk/), [Vascular tumours (angiosarcoma, epithelioid haemangioendothelioma, kaposiform haemangioendothelioma)](https://onco.cc/cancers/vascular-tumours/), [Wilms tumour (nephroblastoma)](https://onco.cc/cancers/wilms-tumor/), [WNT-activated medulloblastoma](https://onco.cc/cancers/medulloblastoma-wnt/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Generic sterile injectables (the 2023 platinum shortage)](https://onco.cc/technologies/sterile-injectable-generics-manufacturing/), [Nerve damage from chemotherapy: what recovers, and what helps](https://onco.cc/technologies/cipn-recovery-and-treatment/), [Small-molecule API synthesis](https://onco.cc/technologies/small-molecule-api-synthesis/)
- companies: [Acrotech Biopharma](https://onco.cc/companies/acrotech-biopharma/), [Eli Lilly (incl. Loxo)](https://onco.cc/companies/eli-lilly/)
- trials: [A Combination of Acalabrutinib With R-CHOP in Subjects With Previously Untreated Non-GCB DLBCL (ACE-LY-312)](https://onco.cc/trials/nct04529772/), [A Phase III Trial Comparing Tisagenlecleucel to Standard of Care (SoC) in Adult Participants With r/r Follicular Lymphoma](https://onco.cc/trials/nct05888493/), [A Study of AZD0486 Monotherapy or in Combination With Other Anti-Cancer Agents for Mature B-Cell Malignancies](https://onco.cc/trials/nct06564038/), [A Study of Treatment for Medulloblastoma Using Sodium Thiosulfate to Reduce Hearing Loss](https://onco.cc/trials/nct05382338/), [A Study to Compare How Well Odronextamab Combined With Chemotherapy Works and How Safe it is Against Rituximab Combined With Chemotherapy, in Adult Pa](https://onco.cc/trials/nct06091865/), [A Study to Compare the Efficacy and Safety of Golcadomide in Combination With Rituximab (Golca + R) vs Investigator's Choice in Participants With Rela](https://onco.cc/trials/nct06911502/), [A Study to Evaluate Adverse Events and Change in Disease Activity of Subcutaneous (SC) Epcoritamab As Monotherapy or Combined With Standard of Care Th](https://onco.cc/trials/nct05201248/), [A Study to Evaluate the Efficacy and Safety of Golcadomide in Combination With Rituximab in Participants With Newly Diagnosed Advanced Stage Follicular Lymphoma](https://onco.cc/trials/nct06425302/), [A Study to Evaluate the Safety and Efficacy of Glofitamab in Combination With Rituximab (R) Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) in Circulating Tumor (ct)DNA High-Risk Patients With Untreated Diffuse Large B-Cell Lymphoma](https://onco.cc/trials/nct04980222/), [A Study to Evaluate Zilovertamab Vedotin (MK-2140) Combination With Rituximab Plus Cyclophosphamide, Doxorubicin, and Prednisone (R-CHP) Versus Rituxi](https://onco.cc/trials/nct06717347/), [A Trial to Learn if Odronextamab Combined With Chemotherapy is Safe and Well-Tolerated and How Well it Works Compared to Rituximab Combined With Chemo](https://onco.cc/trials/nct06097364/), [A Trial to Learn if Odronextamab is Safe and Well-Tolerated and How Well it Works Compared to Rituximab Combined With Different Types of Chemotherapy ](https://onco.cc/trials/nct06091254/), [ACNS0121](https://onco.cc/trials/acns0121/), [ACNS0333](https://onco.cc/trials/acns0333/), [ACNS1422](https://onco.cc/trials/acns1422/), [ACTG A5263/AMC 066](https://onco.cc/trials/actg-a5263/), [AEWS0031](https://onco.cc/trials/aews0031/), [AHL2011](https://onco.cc/trials/ahl2011/), [AHOD1331](https://onco.cc/trials/ahod1331/), [Alliance/CALGB 50303](https://onco.cc/trials/calgb-50303/), [ANBL17P1](https://onco.cc/trials/anbl17p1/), [ARCHED](https://onco.cc/trials/arched/), [Clinical Study of XNW5004 Combined With CHOP/CHOEP in the Treatment of Untreated Peripheral T-Cell Lymphoma](https://onco.cc/trials/nct07730515/), [CODEL](https://onco.cc/trials/codel/), [COG ACNS0331](https://onco.cc/trials/acns0331/), [COG ACNS0332](https://onco.cc/trials/acns0332/), [COG AREN0532](https://onco.cc/trials/aren0532/), [COG AREN0533](https://onco.cc/trials/aren0533/), [Combination Chemotherapy in Treating Young Patients With Newly Diagnosed High-Risk B Acute Lymphoblastic Leukemia and Ph-Like TKI Sensitive Mutations](https://onco.cc/trials/nct02883049/), [Combination Chemotherapy With or Without Lestaurtinib in Treating Younger Patients With Newly Diagnosed Acute Lymphoblastic Leukemia](https://onco.cc/trials/nct00557193/), [ECHELON-2](https://onco.cc/trials/echelon-2/), [ENRICH](https://onco.cc/trials/enrich/), [EORTC 26951](https://onco.cc/trials/eortc-26951/), [EORTC/LYSA/FIL H10](https://onco.cc/trials/eortc-h10/), [Erythropoietin for Management of Anemia Caused by Chemotherapy](https://onco.cc/trials/nct02890602/), [EuroNet-PHL-C2](https://onco.cc/trials/euronet-phl-c2/), [FLYER](https://onco.cc/trials/flyer/), [GALLIUM](https://onco.cc/trials/gallium/), [GHSG HD18](https://onco.cc/trials/hd18/), [GOYA](https://onco.cc/trials/goya/), [High-Risk Neuroblastoma Study 2 of SIOP-Europa-Neuroblastoma (SIOPEN)](https://onco.cc/trials/nct04221035/), [Inotuzumab Ozogamicin and Frontline Chemotherapy in Treating Young Adults With Newly Diagnosed B Acute Lymphoblastic Leukemia](https://onco.cc/trials/nct03150693/), [Inter-B-NHL Ritux 2010](https://onco.cc/trials/inter-b-nhl-ritux-2010/), [International Collaborative Treatment Protocol For Children And Adolescents With Acute Lymphoblastic Leukemia](https://onco.cc/trials/nct01117441/), [JCOG9801](https://onco.cc/trials/jcog9801/), [Mosunetuzumab with lenalidomide in relapsed marginal zone lymphoma](https://onco.cc/trials/mosun-len-mzl/), [POLAR BEAR](https://onco.cc/trials/polar-bear/), [Prevention of Anthracycline-Induced Cardiac Dysfunction With Dexrazoxane in Patients With Diffuse Large-B Cell Lymphoma](https://onco.cc/trials/nct06220032/), [PRIMA](https://onco.cc/trials/prima-follicular/), [PTLD-1](https://onco.cc/trials/ptld-1/), [RELEVANCE](https://onco.cc/trials/relevance/), [Rituximab, Rasburicase, and Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Advanced B-Cell Leukemia or Lymphoma](https://onco.cc/trials/nct00057811/), [RTOG 9402](https://onco.cc/trials/rtog-9402/), [Safety and Efficacy of Asciminib in Pediatrics and Young Adults With Relapse/Refractory (r/r) Philadelphia Positive (Ph+) or ABL-class Ph-like Acute Lymphoblastic Leukemia (ALL)](https://onco.cc/trials/nct07387926/), [Safety and Efficacy of Pembrolizumab (MK-3475) in Children and Young Adults With Classical Hodgkin Lymphoma (MK-3475-667/KEYNOTE-667)](https://onco.cc/trials/nct03407144/), [Safety and Efficacy Study of Epcoritamab in Subjects With Relapsed/Refractory Chronic Lymphocytic Leukemia and Richter's Syndrome](https://onco.cc/trials/nct04623541/), [Safety and Efficacy Trial of Epcoritamab Combinations in Subjects With B-cell Non-Hodgkin Lymphoma (B-NHL)](https://onco.cc/trials/nct04663347/), [SJMB12](https://onco.cc/trials/sjmb12/), [Study of Subcutaneous Epcoritamab in Combination With Intravenous Rituximab and Oral Lenalidomide (R2) to Assess Adverse Events and Change in Disease ](https://onco.cc/trials/nct06191744/), [TADPOLE (CDRB436G2201)](https://onco.cc/trials/tadpole/), [Therapy for Pediatric Relapsed or Refractory Precursor B-Cell Acute Lymphoblastic Leukemia and Lymphoma](https://onco.cc/trials/nct01700946/), [Treatment of Patients With Newly Diagnosed Acute Myeloid Leukemia or Myelodysplasia](https://onco.cc/trials/nct00136084/), [Treatment Protocol of the NHL-BFM and the NOPHO Study Groups for Mature Aggressive B-cell Lymphoma and Leukemia in Children and Adolescents](https://onco.cc/trials/nct03206671/), [Trial of the Safety and Efficacy of Epcoritamab in Japanese Subjects With Relapsed or Refractory (R/R) B-Cell Non-Hodgkin Lymphoma (R/R B-NHL)](https://onco.cc/trials/nct04542824/), [TRIANGLE](https://onco.cc/trials/triangle/), [TROG 99.03](https://onco.cc/trials/trog-99-03/), [Tucidinostat in Combination With CHOP in Newly Diagnosed Peripheral T-Cell Lymphoma With Follicular Helper of T Cell Phenotype](https://onco.cc/trials/nct06947967/)
- terms: [FOXO1 fusion status and IRS group (rhabdomyosarcoma)](https://onco.cc/terms/foxo1-fusion-status/), [Histological response to induction chemotherapy (osteosarcoma and Ewing sarcoma)](https://onco.cc/terms/histological-response-induction/), [Peripheral neuropathy (chemotherapy-induced)](https://onco.cc/terms/peripheral-neuropathy/), [R-CHOP (lymphoma chemoimmunotherapy)](https://onco.cc/terms/r-chop/), [The lymphoma regimen alphabet: R-CHOP, pola-R-CHP, DA-EPOCH-R, ABVD, BEACOPP and the rest](https://onco.cc/terms/lymphoma-tx-regimen-alphabet/), [Wilms tumour risk markers (anaplasia, 1p/16q loss, 1q gain, SIOP and COG risk groups)](https://onco.cc/terms/wilms-risk-markers/)
- key papers: [ACTG A5263/AMC 066: three chemotherapy regimens with antiretroviral therapy for advanced AIDS-associated Kaposi sarcoma in resource-limited settings](https://onco.cc/key-papers/paper-actg-a5263-kaposi-sarcoma-resource-limited-krown-lancet-2020/), [Dose-adjusted EPOCH-R compared with R-CHOP as frontline therapy for diffuse large B-cell lymphoma: clinical outcomes of the phase III intergroup trial Alliance/CALGB 50303](https://onco.cc/key-papers/paper-calgb-50303-da-epoch-r-vs-r-chop-jco-2019/), [Early positron emission tomography response-adapted treatment in stage I and II Hodgkin lymphoma: final results of the randomized EORTC/LYSA/FIL H10 trial](https://onco.cc/key-papers/paper-eortc-h10-pet-adapted-early-hodgkin-jco-2017/), [Early relapse of follicular lymphoma after R-CHOP defines patients at high risk for death: an analysis from the National LymphoCare Study](https://onco.cc/key-papers/paper-casulo-pod24-follicular-lymphoma-jco-2015/), [EMA/CO for high-risk gestational trophoblastic tumours: results from a cohort of 272 patients](https://onco.cc/key-papers/paper-bower-ema-co-high-risk-gtn-charing-cross-jco-1997/), [EORTC 26951: adjuvant PCV after radiotherapy for anaplastic oligodendroglial tumours, long-term follow-up](https://onco.cc/key-papers/paper-eortc-26951-van-den-bent-jco-2013/), [Four versus six cycles of CHOP chemotherapy in combination with six applications of rituximab in patients with aggressive B-cell lymphoma with favourable prognosis (FLYER)](https://onco.cc/key-papers/paper-flyer-four-vs-six-cycles-r-chop-lancet-2019/), [Ibrutinib and rituximab versus immunochemotherapy in patients with previously untreated mantle cell lymphoma (ENRICH): a randomised, open-label, phase 2/3 superiority trial](https://onco.cc/key-papers/paper-enrich-ibrutinib-rituximab-mantle-cell-lancet-2025/), [Obinutuzumab or rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone in previously untreated diffuse large B-cell lymphoma](https://onco.cc/key-papers/paper-goya-obinutuzumab-vs-rituximab-chop-dlbcl-jco-2017/), [PET-adapted treatment for newly diagnosed advanced Hodgkin lymphoma (AHL2011): a randomised, multicentre, non-inferiority, phase 3 study](https://onco.cc/key-papers/paper-ahl2011-pet-adapted-treatment-advanced-hodgkin-lancet-oncol-2019/), [PET-guided treatment in patients with advanced-stage Hodgkin's lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group](https://onco.cc/key-papers/paper-ghsg-hd18-pet-guided-escalated-beacopp-lancet-2017/), [POLARIX: swapping vincristine for the antibody-drug conjugate polatuzumab vedotin in first-line treatment of diffuse large B-cell lymphoma](https://onco.cc/key-papers/paper-polarix-polatuzumab-rchp-nejm-2022/), [Randomized phase III trial of ibrutinib and R-CHOP in non-germinal centre B-cell diffuse large B-cell lymphoma (PHOENIX)](https://onco.cc/key-papers/paper-phoenix-ibrutinib-r-chop-non-gcb-dlbcl-jco-2019/), [Randomized trial of systemic therapy after involved-field radiotherapy in patients with early-stage follicular lymphoma: TROG 99.03](https://onco.cc/key-papers/paper-trog-99-03-radiotherapy-systemic-therapy-early-follicular-jco-2018/), [RTOG 9802: radiation plus procarbazine, lomustine and vincristine in high-risk low-grade glioma](https://onco.cc/key-papers/paper-rtog-9802-buckner-nejm-2016/), [VCAP-AMP-VECP compared with biweekly CHOP for adult T-cell leukemia-lymphoma: Japan Clinical Oncology Group Study JCOG9801](https://onco.cc/key-papers/paper-jcog9801-vcap-amp-vecp-adult-t-cell-leukaemia-jco-2007/)
- ideas: [Randomised evidence for the T-cell lymphomas, including the ones that are not in Europe or North America](https://onco.cc/ideas/lymphoma-ev-randomised-evidence-for-the-t-cell-lymphomas/), [The drugs that cure lymphoma, and the places that do not have them](https://onco.cc/ideas/lymphoma-ev-the-drugs-that-cure-and-the-places-without-them/)
- targets: [Tubulin (microtubules)](https://onco.cc/targets/tubulin/)
- people: [Donald Pinkel](https://onco.cc/people/donald-pinkel/), [Emil J Freireich](https://onco.cc/people/emil-freireich/)
- drugs: [TK216](https://onco.cc/drugs/tk216/), [Vindesine](https://onco.cc/drugs/vindesine/)
- pathways: [Mitosis & the spindle assembly checkpoint](https://onco.cc/pathways/mitotic-spindle-checkpoint/)
- roadmaps: [Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs](https://onco.cc/roadmaps/chemotherapy-roadmap/), [Drug discovery roadmap: screening in mice → maps of dependency → designing in silico](https://onco.cc/roadmaps/drug-discovery-roadmap/), [Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first](https://onco.cc/roadmaps/paediatric-oncology-roadmap/)

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