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Antitumor antibiotics Advantages
Advantage: drugs are active throughout the cell cycle, but most toxic for cells in S-phase or G2
Antitumor antibiotics disadvantages
Disadvantage: the ability to generate free radicals can lead to cardiac toxicity
- 5-fluorouracil (5-FU)
- 6-mercaptopurine (6-MP)
- Capecitabine (Xeloda®)
- Cytarabine (Ara-C®)
- Gemcitabine (Gemzar®)
- Pemetrexed (Alimta®)
Not associated with delayed or prolonged myelosuppresion Present minimal risk for leukemogenesis and/or carcinogenesis
Exhibits plateau in cell survival with increasing dose
- Nitrogen mustards: such as mechlorethamine (nitrogen mustard), chlorambucil, cyclophosphamide (Cytoxan®), ifosfamide, and melphalan
- Nitrosoureas: which include streptozocin, carmustine (BCNU), and lomustine
- Alkyl sulfonates: busulfan
- Triazines: dacarbazine (DTIC) and temozolomide (Temodar®) •Ethylenimines: thiotepa and altretamine (hexamethylmelamine)
Alkylating agents disadvantages
- Toxic to bone marrow stem cells
- Produce delayed, prolonged or even permanent bone marrow failure
- Often cause irreversible infertility
- Mutagenic and carcinogenic effect on bone marrow stem cells ultimately arising in acute myelogenous leukemia (AML)
Alkylating agents advantages
- Are not phase-specific and have the ability to kill non-proliferating cells, which makes them choice drugs for tumors with low growth fractions
- Have an almost infinite number of potential DNA disruption sites
- They do not typically exhibit a plateau in cell survival with increasing dose
Vinca alkaloids (plant)
- They bind to the protein tubulin (which normally forms the apparatus along which chromosomes migrate during mitosis) and arrest the cell growth
- Vincristine important for childhood ALL and in combo with other drugs for lymphomas
- Vinblastine for testicular cancer
Etoposide (plant alkaloid)
- Also causes metaphase arrest and induce DNA strand breaks
- Key for nonseminomatous testicular cancer, non-Hodgkin’s lymphoma, and small-cell lung cancer
- Drugs in this category are sex hormones, or hormone-like drugs, that change the action or production of female or male hormones. They are used to slow the growth of breast, prostate, and endometrial cancers.
- They do not work in the same ways as standard chemotherapy drugs, but rather by preventing the cancer cell from using the hormone it needs to grow, or by preventing the body from making the hormones.
Some drugs are given to people with cancer to stimulate their natural immune systems to recognize and attack cancer cells. These drugs offer a unique method of treatment, and are often considered to be separate from chemotherapy.
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