MED ORG anti cancer

• Cancer


  Uncontrolled growth of abnormal cells in the body
• Cell cycle phases targeted by cancer drugs

  1. G1 phase: Asparaginase and Pegaspargase

  2. S phase: Antimetabolites (Anti-folates and Purine and Pyrimidine Analogues)

  3. G2 phase: Bleomycin

  4. M Phase: Vincas, Taxanes

  
• Cancer drugs that target cells at any phase of the cell cycle

  • Alkylating agents
  • Antitumor Antibiotics
  • Anthracyclines
  • Platinum analogs
  • Antimetabolites

  
• Antifolates


  Methotrexate, Pemetrexed, Pralatrexate - Inhibit the dihydrofolate reductase enzymes
• Antifolates


  • Methotrexate
  • Pemetrexed
  • Pralatrexate
• Pemetrexed


  Used for non-small cell lung cancer

  
• Pralatrexate


  Used in relapsed or refractory T-cell lymphoma
• Leucovorin (Folic Acid) administration

  1. IM 1 wk before the treatment then every 3 cycles of the tx

  2. Daily dose of folic acid P.O 1mg/ day
• 6-mercaptopurine


  Thiol analog of hypoxanthine, used for maintenance of remission in acute lymphoblastic leukemia, mechanism of action is inhibition of purine synthesis
• Fludarabine


  Useful in the treatment of chronic lymphocytic leukemia
• Cladribine


  Used against hairy cell leukemia, chronic lymphocytic leukemia, non-Hodgkin lymphoma

  
• Capecitabine


  Oral prodrug of 5 fluorouracil, used in the treatment of colorectal and metastatic breast cancer

  
• 5-Fluorouracil


  Used for the treatment of slowly growing solid tumors

  
• Cytarabine


  Used for acute nonlymphocytic leukemia
• Azacitidine


  Used for the treatment of myelodysplastic syndromes and acute nonlymphocytic leukemia
• Gemcitabine


  Commonly used for pancreatic cancer and non small cell lung cancer

  
• Doxorubicin


  Most widely used anticancer medication, useful in combination with other agents for the treatment of sarcomas, acute lymphocytic leukemia and lymphomas

  
• Bleomycin


  Cell specific to G2 phase, used for Hodgkin's lymphoma and testicular cancers, adverse effect is pulmonary fibrosis (Bleomycin lung)
• Cyclophosphamide and Ifosfamide


  Used for non Hodgkin lymphoma, sarcoma and breast cancer, adverse effect is hemorrhagic cystitis leading to bladder fibrosis, remedies are low dose, adequate hydration, and giving MESNA

  
• Carmustine and Lomustine


  Used for the treatment of brain tumors
• Dacarbazine


  Used for the treatment of melanoma and Hodgkin lymphoma
• Temozolamide


  Used for the treatment of metastatic melanoma
• Busulfan


  Effective against chronic granulocytic leukemia, adverse effect is pulmonary fibrosis (Busulfan lung)
• Vinca alkaloids


  • Vincristine
  • Vinblastine
  • Vinorelbine
  • Vindesine
• Vincristine


  Useful in the treatment of acute lymphoblastic leukemia in children, Hodgkin and non Hodgkin lymphoma

  
• Taxanes


  • Paclitaxel
  • Docetaxel
  • Cabazitaxel
• Paclitaxel


  Used for ovarian and breast cancer
• Docetaxel


  Used for prostate, breast, GI and non-small cell lung cancer

  
• Cabazitaxel


  Used for metastatic prostate cancer
• Taxanes and Vinca alkaloids

  Adverse effects are hypersensitivity/allergic reactions, treated with antihistamine and glucocorticoid
• Trastuzumab


  Targets Human epidermal receptor 2 (HER 2), used for metastatic breast cancer, adverse effect is congestive heart failure
• Rituximab


  First monoclonal antibody approved for cancer treatment, targets CD20 in B lymphocytes, effective in lymphomas, chronic lymphocytic leukemia and rheumatoid arthritis

  
• Bevacizumab


  Targets Vascular Endothelial growth factor (VEGF), used as first line drug against metastatic colorectal cancer with 5-FU chemotherapy

  
• Cetuximab and Panitumumab


  Target Epithelial Growth Factor receptor (EGFR), used to treat KRAS wild-type metastatic colorectal cancer, head and neck cancer

  
• Cisplatin


  Most toxic platinum compound, used for solid tumors and metastatic testicular carcinoma

  
• Carboplatin


  Less nephrotoxic than cisplatin
• Oxaliplatin


  Most useful for the treatment of lower GI cancers, very sensitive

  
• Imatinib


  Used for the treatment of myelogenous leukemia as well as GI stromal tumors

  
• Dasatinib, Nilotinib


  Target BCR-ABL kinase
• Erlotinib


  An inhibitor of the epidermal growth factor receptor tyrosine kinase, used for non small cell lung cancer and pancreatic cancer