Cancer and anti neoplastic agents

The medical term for tumor (or) cancer is Neoplasm, Which means a relatively autonomous growth (or) un corodinated cell proliferation of body tissue.The branch of medicine which deals with the excessive study of neoplasm (tumor) and its development diagnosis and treatment is called “Oncology.”
The term cancer was translated from a Latin word carcino i.e. Crab by celsus.
For the first time Hippocrates coined the Greek word Karkinos i.e. (crab/cray fish) for malignant breast cancer
Agents used to treat such abnormal cell productions are known as anti neoplastic agents.they are 1.Alkylating agents:-
Nitrogen mustards
Cyclophosphamide
Meclorethamine
2.Antimetabolites:-
purine antagonist:-6-mercaptopurine
Folic acid antagonist:-methotrexate
Pyrimidine antagonist:-5-flurouracil
3.Plant products:-
Vinca alkaloids
Vincrystine
vinblastine

4.Anti biotics:-
Doxorubicin
Actinomycin

5.Hormonal agents:
Tamoxifen
Glucocorticosteroids

6.Miscellaneous:-
Hydroxy urea
Asparginase
Public education campaigns are important in highlighting the dangers of smoking, because possibly as many as 30% of cancers are caused by smoking, excessive drinking, and hazardous solvents, as well as promoting healthy diets and lifestyles.
30% of cancers are diet related that’s why everybody should take healthy diets and lifestyles.
The benefits of eating high-fibre foods, fruit, and vegetables are clear.
Infact, there have been various research projects aimed at identifying the specific chemicals in these foods which are responsible for this protective property.

1. ANTI NEOPLASTIC AGENTS 1 By Nakka varshitha

2. CONTENTS INTRODUCTION HISTORY EPIDEMIOLOGY CAUSE PATHOGENESIS CLASSIFICATION DIAGNOSIS ANTI NEOPLASTICS AGENTS 2

3. INTRODUCTION The medical term for tumor (or) cancer is Neoplasm , Which means a relatively autonomous growth (or) un corodinated cell proliferation of body tissue. 3

4. HISTORY The branch of medicine which deals with the excessive study of neoplasm (tumor) and its development diagnosis and treatment is called “ Oncology. ” The term cancer was translated from a Latin word carcino i.e. Crab by celsus . For the first time Hippocrates coined the Greek word Karkinos i.e. (crab/cray fish) for malignant breast cancer 4

5. EPIDEMIOLOGY FEMALE MALE Worldwide, it is estimated that about 20% of all deaths are cancer-related. Due to varying etiologic factors, cancers of the cervix and oral cavity are more common in India while cancers of the breast and lung are commoner in the Western populations. 5

6. CAUSES?? 6

7. PATHOGENESIS 7

8. PATHOGENESIS 8

9. SELF SUFFICIENCY IN GROWTH SIGNALS The mechanisms that endow cancer cells with the ability to proliferate can be grouped according to their role in the growth factor–induced signal transduction cascade and cell cycle regulation . They are Growth Factors Growth Factor Receptors & Non- ReceptorTyrosine Kinases Downstream Signal-Transducing Proteins Nuclear Transcription Factors Cyclins and Cyclin-Dependent Kinases 9

10. IN SENSITIVE TO ANTI GROWTH SIGNALS RB Gene: Governor of the Cell Cycle TP53 Gene: Guardian of the Genome Transforming Growth Factor- β Pathway Contact Inhibition, NF2, and APC 10

11. EVADING APOPTOSIS Apoptosis can be initiated through extrinsic or intrinsic Pathways. Both pathways result in the activation of a proteolytic cascade of caspases that destroys the cell. Mitochondrial outer membrane permeabilization is regulated by the balance between pro-apoptotic (e.g., BAX,BAK) and anti-apoptotic molecules (BCL2, BCL-XL). BH-3–only molecules activate apoptosis by tilting the balance in favor of the pro-apoptotic molecules. 11

12. SUSTAINED ANGIOGENESIS Vascularization of tumors is essential for their growth and is controlled by the balance between angiogenic and antiangiogenic factors that are produced by tumor and stromal cells. Hypoxia triggers angiogenesis through the actions of HIF-1α on the transcription of the pro-angiogenic factor VEGF.Because of its ability to degrade HIF-1α and thereby prevent angiogenesis, VHL acts as a tumor suppressor. Inheritance of germ line mutations of VHL causes VHL syndrome, characterized by the development of a variety of tumors. 12

13. LIMITLESS REPLICATIVE POTENTIAL In normal cells, which lack expression of telomerase, the shortened telomeres generated by cell division eventually activate cell cycle checkpoints, leading to senescence and placing a limit on the number of divisions a cell may undergo. In cells that have disabled checkpoints, DNA repair pathways are inappropriately activated by shortened telomeres, leading to massive chromosomal instability and mitotic crisis. Tumor cells reactivate telomerase, thus staving off mitotic catastrophe and achieving immortality. 13

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15. TISSUE INVASION AND METASTATIS Ability to invade tissues, a hallmark of malignancy, occurs in four steps: loosening of cell–cell contacts Degradation of ECM attachment to novel ECM components migration of tumor cells 15

16. CLASSIFICATION 16

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18. TYPES OF CANCERS Carcinoma Sarcoma Leukemia Lymphoma Blastoma Melanoma Adenomas Gliomas Germ cell tumors 18

19. DIAGNOSIS Symptomatic identification Lab test Imaging procedure CT scan Nuclear scan Ultra sound MRI PET scan X-rays Biopsy Neddle Endoscopy Surgery CT scan Ultra sound PET scan X-rays mamograph 19

20. TREATMENT 20

21. Classification of anticancer agents 1.Alkylating agents:- Nitrogen mustards Cyclophosphamide Meclorethamine 2.Antimetabolites:- purine antagonist:- 6-mercaptopurine Folic acid antagonist:- methotrexate Pyrimidine antagonist:- 5-flurouracil 3.Plant products:- Vinca alkaloids Vincrystine vinblastine 21

22. 4.Anti biotics:- Doxorubicin Actinomycin 5.Hormonal agents: Tamoxifen Glucocorticosteroids 6.Miscellaneous:- Hydroxy urea Asparginase 22

23. Alkylating agents Alkylation is defined as the replacement of hydrogen on an atom by an alkyl group. Nitrogen mustard:- Nitrogenmusterds get their name because they related to sulfur containing mustard gases used during first world war. These are unstable as their cytotoxic effect towards the proliferating cell insists their use . Structure of cyclophosphamide It is 2-bis-(2-chloroethyl)amino-perhydro-1,3,2-oxazaphosphorinane-2-oxide mono hydrate. 23

24. Properties Readily soluble in water. Melting point- 41-45 c. Soluble in alcohol, benzene, ethylene glycol,carbon - tetrachloride, dioxane. It is available in tablets and injections. Uses Treatment of Hodgkin's disease Acute lymphocytic leukemia Breast,cervix,lung,ovary tumors. 24

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26. Meclorethamine It is also known as mustine or chlormethethine. It is 2-chloro-N-(2-chloroethyl)-N-methylethanmine. 26

27. Properties Properties Mechlorethamine is available as Hcl salt. Mechlorethamine Hcl is white crystalline power. It is hygroscopic and freely soluble in water. Uses Hodgkin’s disease Other lymphomas 27

28. Anti metabolites Anti metabolites are the agents which inhibit the enzymes involved in the synthesis of DNA (or)it’s nucleotide building blocks. The inhibitors involved are described as antimetabolites generally the cellular components like folic acids,purines.that are involved in the synthesis of nucleic acids(DNA,RNA). Anti-metabolites inhibits nucleic acids synthesis by competitive inhibition of cellular components . 28

29. Purine antagonist:6-mercaptopurine It is 1,7-dihydro-6H-purine-6-thione. 29

30. Properties It is available as yellow prisms having a decomposion temperature of 313 c . It is insoluble in water, acetone, ether. It is soluble in alkali solutions . Uses It has immunosuppressant action. It is used in the treatment of acute myelocytic leukemia. 30

31. Folic acid antagonist: methotrexate It is 4-amino-(N10)-methylpteroylglutamic acid. 31

32. Mechanism of action 32

33. properties Methyltrexate is available as yellow crystals having a decomposition temperature of 204 c. It is soluble in alkaline or acidic solutions . Insoluble in water. Uses Used in the treatment of gestational choriocarcinoma. Trophoblstic tumors of women. Acute lympholytic leukemia in children. Psoriasis, breast, lung, cancer . 33

34. Pyrimidine antagonist 5-flurouracil: It is chemically 5-fluro-2,4(1H,3H) pyrimidienedione . 34

35. Properties white crystalline power. sparingly soluble in water and is a light sensitive compound. Uses used in the tumors. used topically in treatment of basal cell carcinomas and premalignant skin keratoses. 35

36. Vinca alkaloids Vinblastine: Obtained from “cathranthus roseus”. Vinblastine having 2 moites. 1.Catharanthine 2.vindoline 36

37. Properties White to slightly yellow colour crystalline odour less powder. Soluble in water, methanol,ethanol,chlorform. Insoluble in ether having melting point 280 c. Uses Testicular cancer & ovarian cancer Hodgkin’s disease. Non-Hodgkin’s lymphoma Kaposi’s sarcoma. 37

38. Vincrystine It is also obtained from the “catharanthus roseus” 38

39. properties white to yellow odourless crystals. Freely soluble in water, insoluble in ether. having melting point 22 c. Uses Acute leukemia Hodgkin’s lymphoma, Burkett's lymphoma, Wilm’s tumor Brain, lung, breast, head tumors. 39

40. Anti-biotics The cytotoxic nature of antibiotics used in the treatment of cancer. Actionomycins: produced from “streptomyces chrysomallus”. 40

41. Properties Bright red rhomboid prisms, having melting point 241-243 c. Soluble in alcohol, propylene glycol in mixture of water & glycol . Mechanism of action Actinomycins interrelate into double-helical DNA and interfere with it’s template function. Uses Rabdomyosacroma&wilm’s tumor. Uterus & testis tumors . 41

42. Doxorubicin O btained from “streptomycin chrysomallus” 42

43. Properties Orange coloured needles having melting point 204-205 c. Soluble in water and aqueous alcohols, methanol. Insoluble in acetone, benzene, chloroform, ether . Uses Treatment of leukemia Hodgkin’s disease Neuroblastoma Breast & ovarian cancer 43

44. Hormonal agents Adrino cortico steroids: Prednisone : Uses Adrino Cortico Carcinoma Prostatic Carcinoma 44

45. Tamoxifen 45 Properties It is fine, white odorless, crystalline powder having melting point of 140 It is slightly soluble in water and soluble in ethanol, methanol and acetone . Uses Used in Advanced breast cancer.

46. Miscellaneous Asparaginase Uses Used in breast cancer . 46

47. Alternatives For Antineoplastic Agents : 30% cancers are diet related. Dithiolthiones are a group of chemicals in broccoli, cauliflower, cabbage one of which involves the activation of enzymes in the liver to detoxify carcinogens. Genistein is a protective compound found in soya products . Antioxidant present in green tea . 47

48. CONCLUSION Public education campaigns are important in highlighting the dangers of smoking, because possibly as many as 30% of cancers are caused by smoking, excessive drinking, and hazardous solvents, as well as promoting healthy diets and lifestyles. 30% of cancers are diet related that’s why everybody should take healthy diets and lifestyles. The benefits of eating high- fibre foods, fruit, and vegetables are clear. Infact , there have been various research projects aimed at identifying the specific chemicals in these foods which are responsible for this protective property. 48

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