II. Indications
- FDA Approved
- Ewing's Sarcoma
- Gestational Trophoblastic Neoplasia (Molar Pregnancy)
- Non-seminomatous Testicular Cancer
- Rhabdomyosarcoma
- Wilms Tumor
- Off-label use
- Osteosarcoma
- Ovarian Cancer germ cell tumors
- Soft Tissue Sarcoma
III. Contraindications
- Active Varicella Zoster Virus (Chicken Pox)
- Active Shingles (Herpes Zoster)
- Age <6 months
IV. Mechanism
- See Antibiotic Chemotherapy
- Dactinomycin is a chromopeptide Antineoplastic Antibiotic extracted from the bacterium Streptomyces parvulus
- Dactinomycin inserts between adjacent guanine-cytosine base pairs
- Blocks DNA Transcription by RNA Polymerase
- Dactinomycin also induces single stranded DNA breaks by several postulated mechanisms
- Free-radical intermediate
- Topoisomerase 2 interaction
V. Medications
- Dactinomycin injection powder for solution in 0.5 mg vials
VI. Dosing
- See other references for disease specific dosing protocols
- Caution that dosing units may be written in either mg or mcg
VII. Adverse Effects
VIII. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters)
- Use reliable Contraception
IX. Resources
- Dactinomycin injection powder for solution (DailyMed)