Common brand names

• Oncaspar

How it is administered

Pegaspargase is given as an injection, either into a muscle (intramuscularly) or into a vein (intravenously). It is supplied as a clear, colorless solution in a vial. The medication is typically administered in a healthcare setting by a medical professional.

For patients 21 years old or younger, the recommended dose is 2,500 International Units per square meter of body surface area, given no more frequently than every 14 days. For adults older than 21 years, the dose is 2,000 International Units per square meter. If given intramuscularly, the volume at a single injection site should not exceed 2 mL; larger doses are divided between multiple sites. For intravenous use, the medication is diluted and infused over 1 to 2 hours.

How it works

Pegaspargase is an enzyme that breaks down the amino acid L-asparagine into aspartic acid and ammonia. Certain cancer cells, like those in acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma, cannot make enough asparagine on their own and rely on the supply from the bloodstream. By depleting asparagine, pegaspargase starves these cancer cells, leading to their death.

Healthy cells can produce their own asparagine and are less affected by this treatment. The medication works as part of a multi-drug chemotherapy regimen, helping to improve the effectiveness of cancer treatment by targeting the unique vulnerability of lymphoblastic cancer cells.

Who should take it

Pegaspargase is indicated for pediatric and adult patients as part of a multi-agent chemotherapy regimen for the treatment of acute lymphoblastic leukemia (ALL), including those who are being treated for the first time and those who have developed hypersensitivity to other forms of asparaginase.

It is also used in the treatment of lymphoblastic lymphoma, as these diseases are closely related. Pegaspargase is especially important for patients who cannot tolerate native forms of L-asparaginase due to allergic reactions.

Who should not take it

Pegaspargase should not be used in patients who have had serious allergic reactions (including anaphylaxis) to pegaspargase or any of its ingredients. It is also contraindicated in patients with a history of serious blood clots (thrombosis), pancreatitis (including pancreatitis related to prior asparaginase therapy), or serious bleeding events with prior asparaginase therapy.

Patients with severe liver impairment should not receive pegaspargase. If you have a history of these conditions, it is important to inform your healthcare provider before starting treatment.

Commonly used with

Pegaspargase is almost always used as part of a multi-agent chemotherapy regimen for blood cancers like ALL and lymphoblastic lymphoma. It is commonly combined with medications such as vincristine, corticosteroids (like dexamethasone or prednisone), anthracyclines (like doxorubicin), and other chemotherapy agents.

The exact combination and schedule depend on the specific treatment protocol being followed.

Commonly tested with

Pegaspargase has been tested in combination with other chemotherapy agents as part of standard treatment protocols for ALL and lymphoblastic lymphoma. These regimens often include drugs such as vincristine, corticosteroids, anthracyclines, and sometimes methotrexate or cytarabine.

Clinical trials have evaluated pegaspargase both in newly diagnosed patients and in those who have experienced hypersensitivity to other asparaginase products.