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Vincristine

Also known as Oncovin, leurocristine, vincristine sulfate

A vinca alkaloid given by intravenous injection, obtained from the periwinkle plant. Its 2026 US label lists acute leukaemia, and use with other drugs in Hodgkin disease, non-Hodgkin lymphomas, rhabdomyosarcoma, neuroblastoma and Wilms tumour.

From discovery to approval

  1. 1962 · Earliest report found

    Vincristine and vinblastine were isolated from the Madagascar periwinkle. No paper read dates the isolation of vincristine itself; the earliest paper found that names it is a 1962 report of initial clinical studies, cited by title only.[2][3][4][5][6][7][1][8]

  2. 1963-07-10 · FDA regular

    Vincristine sulfate injection (Oncovin), NDA 014103, original approval, classed as a new molecular entity with priority review in the Drugs@FDA history. The original label and letter are not available there, so the indication at approval is not stated here; the 2026 generic label lists acute leukaemia and, in combination, Hodgkin disease, non-Hodgkin lymphomas, rhabdomyosarcoma, neuroblastoma and Wilms tumour. The type regular is an inference: no accelerated-approval wording was found.[8]

How it works

The label links its action to inhibition of microtubule formation in the mitotic spindle, which arrests dividing cells at the metaphase stage. The label also says the mechanisms of action of vincristine remain under investigation.[1]

Where it came from and why

A 1990 review by Noble says leaf extracts were reputed in folk medicine to help diabetes, and that attempts to verify this led instead to the discovery and isolation of vinblastine and vincristine. Duffin's history calls the Canadian discovery of vinblastine by Noble and Beer a chance finding and describes similar research at Eli Lilly at the same time.

Vincristine comes from the same plant as vinblastine, the Madagascar periwinkle, Catharanthus roseus [2]. A 1990 review says leaf extracts were reputed in folk medicine to help diabetes, and that attempts to verify this led instead to two alkaloids, vinblastine and vincristine [2]. The review adds that the two are structurally almost identical yet differ markedly in the tumours they affect and in their toxicity [2].

Duffin's history describes the 1950s work of Robert Noble and Charles Beer in Canada on vinblastine as a chance finding of an anticancer drug in periwinkle leaves, and notes that Eli Lilly was doing similar research at the same time [3]. Wani and Horwitz say a mouse leukaemia assay was used at Lilly during the isolation of the vinca alkaloids [4].

The earliest paper found that names vincristine is a 1962 report titled "Initial clinical studies with vincristine", cited here by title only [5]. A 1963 report on its use, as leurocristine, in children with metastatic Wilms tumour is also cited by title only [6]. Drugs@FDA dates the first approval of a vincristine product, Oncovin, to 10 July 1963 [8]. A 2024 review says the periwinkle has in part saved the lives of thousands of children with acute lymphoblastic leukaemia [7].

Cancers

  • Acute leukaemia

    The 2026 US label for vincristine sulfate injection states that it is indicated in acute leukaemia.[1]

  • Hodgkin disease and non-Hodgkin lymphomas

    The label says vincristine has also been shown to be useful in combination with other oncolytic agents in Hodgkin disease and non-Hodgkin malignant lymphomas.[1]

  • Rhabdomyosarcoma, neuroblastoma and Wilms tumour

    The label lists these three childhood solid tumours among those in which vincristine has been shown to be useful in combination with other agents.[1]

  • Wilms tumour (early clinical report)

    A 1963 report titled for vincristine (leurocristine) sulfate in children with metastatic Wilms tumour, from the Southwest Cancer Chemotherapy Study Group, is an early clinical paper; only its title was read.[6]

  • Childhood acute lymphoblastic leukaemia (maintenance schedule)

    A Children's Oncology Group trial, AALL0932, randomised vincristine and dexamethasone pulses every 4 weeks or every 12 weeks during maintenance in standard-risk B-lymphoblastic leukaemia; the authors report outstanding outcomes with the 12-weekly schedule, which uses one third of the previous pulses.[9]

Worth knowing

  • The 2026 US label states that intrathecal administration of vincristine usually results in death, and directs that the diluted preparation be labelled for intravenous use only and fatal if given by other routes.[1]
  • Noble's 1990 review says vinblastine and vincristine are structurally almost identical yet differ markedly in the types of tumour they affect and in their toxic properties.[2]
  • The label notes that central nervous system leukaemia has been reported in patients otherwise responding to vincristine, which it takes to suggest that the drug does not penetrate well into the cerebrospinal fluid.[1]
  • The label says the drug was originally known as leurocristine and has also been called LCR and VCR.[1]
  • Drugs@FDA lists the original Oncovin products under NDA 014103 as discontinued.[8]

On this site

References

  1. Hospira, Inc.. Vincristine sulfate injection: prescribing information. DailyMed, set ID b22e4c8e-dbe1-4d4b-a026-e1812974071c, published 19 February 2026. Source
  2. Noble RL. The discovery of the vinca alkaloids--chemotherapeutic agents against cancer. Biochem Cell Biol. 1990;68(12):1344-51. PubMed
  3. Duffin J. Poisoning the spindle: serendipity and discovery of the anti-tumor properties of the Vinca alkaloids. Can Bull Med Hist. 2000;17(1-2):155-92. PubMedDOI
  4. Wani MC, Horwitz SB. Nature as a remarkable chemist: a personal story of the discovery and development of Taxol. Anticancer Drugs. 2014;25(5):482-7. PubMedDOI
  5. COSTA G, HRESHCHYSHYN MM, HOLLAND JF. Initial clinical studies with vincristine. Cancer Chemother Rep. 1962;24:39-44. PubMed
  6. MACMAHON HE, BEDIZEL M, ELLIS CA. VINCRISTINE (LEUROCRISTINE) SULFATE IN THE TREATMENT OF CHILDREN WITH METASTATIC WILMS' TUMOR. PEDIATRIC DIVISION, SOUTHWEST CANCER CHEMOTHERAPY GROUP. Pediatrics. 1963;32:880-7. PubMed
  7. Taub JW, Buck SA, Xavier AC, Edwards H, Matherly LH, Ge Y. The evolution and history of Vinca alkaloids: From the Big Bang to the treatment of pediatric acute leukemia. Pediatr Blood Cancer. 2024;71(11):e31247. PubMedDOI
  8. U.S. Food and Drug Administration. Drugs@FDA: Approval date(s) and history, letters, labels, reviews for NDA 014103 (vincristine sulfate; Oncovin). Page read 2026-10-29. Source
  9. Angiolillo AL, Schore RJ, Kairalla JA, Devidas M, Rabin KR, Zweidler-McKay P, et al. Excellent Outcomes With Reduced Frequency of Vincristine and Dexamethasone Pulses in Standard-Risk B-Lymphoblastic Leukemia: Results From Children's Oncology Group AALL0932. J Clin Oncol. 2021;39(13):1437-1447. PubMedDOI