Chemotherapy agents

Introduction to anti cancer drugs

1. Introduction to chemotherapy agents Dr. V. S. Swathi Assistant Professor

2. Chemotherapy agents These are the drugs which are used in treatment of cancer Types Alkylating agents Antitumor antibiotics Antimetabolites Mitotic inhibitors Topoisomerase inhibitors Enzymes Protein tyrosine kinase inhibitors Miscellaneous agents

3. Mode of action

4. Alkylating agents Examples Busulfan Carboplatin Cisplatin Oxaliplatin Cyclophosphomide Ifosfamide Adverse effects Myelosupression Peripheral neuropathy Nephrotoxicity Ototoxicity Alopecia Mode of action These are phase non specific agents These acts by cross linking and abnormal base pairing of DNA strands which inhibit replication of DNA and inhibits cancer cell production (Alkylation) Indications Leukaemia Lymphoma Hodgkins disease Multiple myeloma Sarcoma

5. Antitumor antibiotics Examples Bleomycin Doxorubicin Epirubicin Adverse effects Myelosupression Cardiotoxicity Stomatitis Alopecia Nausea and Vomiting M ode of action These are phase non specific agents These acts by sliding between DNA base pairs and inhibit synthesis of DNA and inhibits cancer cell production (Intercalation) Indications Cancer of bladder, breast and bone Other cancers

6. Antimetabolites Examples Cytarabine Fluorouracil Methotrexate Mercaptopurine Gemcitabine Adverse effects Myelosupression Hepatotoxicity Nephrotoxicity Stomatitis Mucositis Mode of action These are S phase specific agents These acts by acting as false substitutions in the production of nucleic acids Indications Leukaemia Cancer of GIT, breast and ovary

7. Antitumor antibiotics Examples Bleomycin Doxorubicin Epirubicin Adverse effects Myelosupression Cardiotoxicity Stomatitis Alopecia Nausea and Vomiting Mode of action These are phase non specific agents These acts by sliding between DNA base pairs and inhibit synthesis of DNA and inhibits cancer cell production (Intercalation) Indications Cancer of bladder, breast and bone Other cancers

8. Mitotic inhibitors Examples Paclitaxel Vincristine Adverse effects Myelosupression Fluid retention Peripheral neuropathy Alopecia Mucositis Mode of action These are M phase specific agents These acts by arresting cell division by preventing microtubules Indications Myeloma Lymphoma Leukaemia Cancer of lung and breast

9. Topoisomerase inhibitors Examples Etopside Adverse effects Myelosupression Hypotension Alopecia Nausea and vomiting Diarrhea Mode of action These are G2 phase specific agents These acts by inhibiting Topoisomerase enzyme which is involved in DNA replication and RNA transcription Indications Leukaemia Cancer of GIT, breast and ovary

10. Examples Aspariginase Adverse effects Allergic reactions Nausea and vomiting Liver dysfunction CNS depression Hyperglycaemia Mode of action These are G1 phase specific agents It acts by breaking asparigine there by no proteins are available for cancer cell production Indications Leukaemia Non Hodgkin’s lymphoma Enzymes

11. Examples Imatinib Nilotinib Adverse effects Myelosupression Hepatotoxicity Fluid retention Nausea and vomiting Diarrhea Mode of action These are target agents These acts by causing apoptosis and arrest the cancer cell growth Indications Liver carcinoma Renal carcinoma Prostatic cancer Leukaemia Lymphoma Protein tyrosine kinase inhibitors

12. Miscellaneous agents Retinoic acid derivatives Tretinoin Isotretinoin Arsenic trioxide Bortezomib Thalidomide Hormones Biological response modifiers Cytokines Monoclonal antibodies Rituximab Trastuzumab