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-
mechlorethamine
(nitrogen mustard), chlorambucil, cyclophosphamide (Cytoxan®),
ifosfamide, and melphalan
-
streptozocin,
carmustine (BCNU), and lomustine
-
-
dacarbazine
(DTIC) and temozolomide (Temodar®)
-
· thiotepa and altretamine (hexamethylmelamine)
-
Alkylating
agents
- Alkylating agents directly damage
- DNA to prevent the cancer cell from reproducing. As a class of drugs, these
- agents are not phase-specific; in other words, they work in all phases of the
- cell cycle. Alkylating agents are used to treat many different cancers,
- including leukemia, lymphoma, Hodgkin disease, multiple myeloma, and sarcoma,
- as well as cancers of the lung, breast, and ovary.
-
Alkylating SE
- Because
- these drugs damage DNA, they can cause long-term damage to the bone marrow. In
- rare cases, this can eventually lead to acute leukemia. The risk of leukemia
- from alkylating agents is “dose-dependent,” meaning that the risk is small with
- lower doses, but goes up as the total amount of the drug used gets higher. The
- risk of leukemia after getting alkylating agents is highest about 5 to 10 years
- after treatment
-
cisplatin,
carboplatin, and oxalaplatin
- The
- platinum drugs ) are sometimes
- grouped with alkylating agents because they kill cells in a similar way. These
- drugs are less likely than the alkylating agents to cause leukemia later on
-
Antimetabolites
- Antimetabolites
- are a class of drugs that interfere with DNA and RNA growth by substituting
- for the normal building blocks of RNA and DNA. These agents damage cells during
- the S phase. They are commonly used to treat leukemias, cancers of the breast,
- ovary, and the intestinal tract, as well as other types of cancer
-
fluorouracil (5-FU)
- 5-fluorouracil (5-FU)
- Antimetablolite
-
6-mercaptopurine
(6-MP
Antimetablolite
-
· Capecitabine (Xeloda®)
Antimetablolite
-
· Cladribine
Antimetablolite
-
· Clofarabine
Antimetablolite
-
-
-
· Floxuridine
· Fludarabine
Antimetablolite
-
· Gemcitabine (Gemzar®)
· Hydroxyurea
-
-
· Methotrexate
· Pemetrexed (Alimta®)
-
-
· Pentostatin
· Thioguanine
Antimetablolite
-
Anthracyclines
- are anti-tumor antibiotics that
- interfere with enzymes involved in DNA replication. These drugs work in all
- phases of the cell cycle. They are widely used for a variety of cancers. A
- major consideration when giving these drugs is that they can permanently damage
- the heart if given in high doses. For this reason, lifetime dose limits are
- often placed on these drugs.
-
· Daunorubicin
· Doxorubicin (Adriamycin®)
Anthracyclines
-
· Epirubicin
· Idarubicin
Anthracyclines
-
· Actinomycin-D
· Bleomycin
· Mitomycin-C
- Other anti-tumor antibiotics
- Mitoxantrone
- is an anti-tumor antibiotic that is similar to doxorubicin in many ways,
- including the potential for damaging the heart. This drug also acts as a
- topoisomerase II inhibitor (see below), and can lead to treatment-related
- leukemia. Mitoxantrone is used to treat prostate cancer, breast cancer,
- lymphoma, and leukemia
-
Topoisomerase
inhibitors
- These
- drugs interfere with enzymes called topoisomerases, which help separate the
- strands of DNA so they can be copied. They are used to treat certain leukemias,
- as well as lung, ovarian, gastrointestinal, and other cancers
- Treatment with topoisomerase II
- inhibitors increases the risk of a second cancer — acute myelogenous leukemia
- (AML). With this type of drug, a secondary leukemia can be seen as early as 2
- to 3 years after the drug is given.
-
Examples
of topoisomerase I inhibitors include
- topotecan
- and irinotecan (CPT-11).
-
Mitotic
inhibitors
- Mitotic inhibitors are often plant
- alkaloids and other compounds derived from natural products. They can stop
- mitosis or inhibit enzymes from making proteins needed for cell reproduction.
- These drugs work during the M phase of the cell
- cycle but can damage cells in all phases. They are used to treat many different
- types of cancer including breast, lung, myelomas, lymphomas, and leukemias.
- These drugs are known for their potential to cause peripheral nerve damage,
- which can be a dose-limiting side effect
-
· Taxanes: paclitaxel (Taxol®) and docetaxel
(Taxotere®)
Mitoticinhibitors
-
· Epothilones: ixabepilone (Ixempra®)
Mitotic inhibitors
-
· Vinca alkaloids: vinblastine (Velban®), vincristine
(Oncovin®), and vinorelbine (Navelbine®)
Mitotic inhibitors
-
· Estramustine (Emcyt®)
Mitotic inhibitors
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