Anticancer Drugs – Uses, Dosage, Side Effects, Interactions

Anticancer Drugs
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Anticancer Drugs is an international medical journal, which aims to promote and encourage research on anti-cancer agents. It was first published in 1990 and it includes reports on clinical and experimental research results, from conventional cytotoxic chemotherapy to hormonal or biological response modalities.

Classification of anticancer drugs

1.    Polyfunctional alkylating agents

  • Nitrosoureas
  • Mustards (Nitrogen Mustards)
  • Methanesulphonates (Busulphan)
  • Ethylenimines

2.    Other Alkylating Drugs

  • Procarbazine (Matulane)
  • Dacarbazine (DTIC)
  • Altretamine (Hexalen)
  • Cisplatin (Platinol)

3.    Antimetabolites

  • Antifolic acid compounds (Methotrexate)
  • Amino acid Antagonists (Azaserine)

4.    Purine antagonists

  • Mercaptopurine (6-MP)
  • Thioguanine (6-TG)
  • Fludarabine Phosphate
  • Cladribine (Leustatin)
  • Pentostatin (Nipent)

5.    Pyrimidine antagonists

  • Fluorouracil (5-FU)
  • Cytarabine (ARA-C)
  • Azacitidine

6.    Plant alkaloids

  • Adult enuresis
  • Vinblastine (Velban)
  • Vincristine (Oncovin)
  • Etoposide (VP-16,VePe-sid)
  • Teniposide (Vumon)
  • Topotecan (Hycamtin)
  • Irinotecan (Camptosar)
  • Paclitaxel (Taxol)
  • Docetaxel (Taxotere)

7.    Antibiotics

  • Anthracyclines
  • Doxorubicin (Adriamycin, Rubex, Doxil)
  • Daunorubicin (DaunoXome)
  • Dactinomycin (Cosmegen)
  • Idarubincin (Idamycin)
  • Plicamycin (Mithramycin)
  • Mitomycin (Mutamycin)
  • Bleomycin (Blenoxane)

8.    Monoclonal Antibodies

  • Introduction
  • Examples

9.    Hormonal agents

  • Adult enuresis
  • Introduction
  • Tamoxifen (Nolvadex)
  • Flutamide (Eulexin)
  • Gonadotropin-Releasing Hormone Agonists
  • (Leuprolide and Goserelin (Zoladex))
  • Aromatase Inhibitors
  • Aminoglutethimide
  • Anastrozole (Arimidex)

10.    Miscellaneous anticancer drugs

  • Adult enuresis
  • Amsacrine
  • Hydroxyurea (Hydrea)
  • Asparaginase (El-spar)
  • Mitoxantrone (Novantrone)
  • Mitotane
  • Retinoic Acid Derivatives
  • Bone Marrow Growth Factors
  • Amifostine
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Mechanism of action of Anticancer Drugs

Anticancer drugs compete with hypoxanthine and guanine for the enzyme hypoxanthine-guanine phosphoribosyltransferase (HGPRTase) and are itself converted to thioinosinic acid (TIMP). This intracellular nucleotide inhibits several reactions involving inosinic acid (IMP), including the conversion of IMP to xanthylic acid (XMP) and the conversion of IMP to adenylic acid (AMP) via adenylosuccinate (SAMP). In addition, 6-methylthioinosinate (MTIMP) is formed by the methylation of TIMP. Both TIMP and MTIMP have been reported to inhibit glutamine-5-phosphoribosylpyrophosphate amidotransferase, the first enzyme unique to the de novo pathway for purine ribonucleotide synthesis. Experiments indicate that radiolabeled mercaptopurine may be recovered from the DNA in the form of deoxythioguanosine. Some mercaptopurine is converted to nucleotide derivatives of 6-thioguanine (6-TG) by the sequential actions of inosinate (IMP) dehydrogenase and xanthate (XMP) aminase, converting TIMP to thioguanylic acid (TGMP).

Indications of Anticancer Drugs

  • Crohn’s disease, 
  • Acute lymphoblastic leukaemia
  • Autoimmune hepatitis
  • Inflammatory bowel disease
  • Intestinal arterial insufficiency
  • Ulcerative colitis, maintenance
  • Acute lymphoblastic leukaemias
  • Acute promyelocytic leukaemia
  • Hepatitis, autoimmune
  • Lymphoma, lymphoblastic
  • Ulcerative colitis
  • Anticancer drugs are approved to be used with other drugs to treat: Acute lymphoblastic leukaemia (ALL). It is used as maintenance therapy in adults and children.
  • Anticancer drugs are indicated for maintenance therapy of acute lymphatic (lymphocytic, lymphoblastic) leukaemia as part of a combination regimen. The response to this agent depends upon the particular subclassification of acute lymphatic leukaemia and the age of the patient (pediatric or adult).
  • Anticancer drugs are not effective for prophylaxis or treatment of central nervous system leukaemia.
  •  Anticancer drugs are also being studied in the treatment of other types of cancer.
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Contra-Indications of Anticancer Drugs

  • Extreme loss of body water
  • Decreased function of bone marrow
  • Anemia
  • Decreased blood platelets
  • Decreased white blood cells
  • Decreased neutrophils a type of white blood cell
  • Stomach or intestinal ulcer
  • Liver Problems
  • Blockage of normal bile flow
  • Acute inflammation of the pancreas
  • kidney disease with reduction in kidney function
  • High amount of bilirubin in the blood
  • Ascites
  • Abnormal liver function tests
  • Pregnancy
  • Thiopurine S-methyltransferase deficiency
  • Hepatosplenic T-cell lymphoma

Side effects of Anticancer Drugs

The most common

More common

Less common

Drug Interactions of Anticancer Drugs

Anticancer drugs may interact with the following drugs, supplements& may change the drug efficacy

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