Alkylating Agents Flashcards
Cyclophosphamide
Tox:
nausea and vomiting
bone marrow depression
bleeding
Applications: breast and ovarian cancer hematologic malignancies (NHL and CLL) soft tissue sarcoma neuroblastoma Wilms tumor rhabdomyosarcoma
Busulifan
Tox: PULMONARY FIBROSIS adrenal insufficiency nausea and vomiting myelosuppression skin pigmentation
Clinical applications:
CML
Bone marrow ablation for glutathione-s-transferase deficiency
Carmustine
Orally available/renal excretion
Highly lipid soluble (CNS)
Tox:
N/V
myelosuppression
Applications:
brain tumors
Procarbazine
Oral
Acts as MAOi (interacts w alcohol, sympathomimetics, TCA, anti-histamines, CNS depressants)
Component of MOPP to treat Hodgkins Disease
Tox: high risk of secondary malignancy nausea, vomiting myelosuppression CNS too
Pt based drugs
Cytotoxic at all stages of cell cycle
Really excreted
Alkylates DNA and proteins
Synergies with other alkylating agents, fluoropyrimidines, taxanes
Cisplatin
Tox HIGHLY EMETOGENIC NEPHROTOX OTOTOX IRREVERSIBLE NERVE DYSFUNCTION
Applications NSCLC and SCLC Head/neck cancer Breast cancer Ovarian cancer Bladder cancer GE junction cancer
Carboplatin
Tox Less renal and GI too vs cisplatin Myelosuppression Peripheral neuropathy Nephro and hepatic tox
Applications NSCLC and SCLC Head/neck cancer Breast cancer Ovarian cancer Bladder cancer
Oxaliplatin
MOA
-also effective in cells with MMR defects
Tox
NEUROTOX; LARYNGOPHARYNGEAL DYSESTHESIA
Peripheral sensory neuropathy (delayed)
Applications
- colorectal cancer (FOLFOX)
- gastroesophageal cancer
- pancreatic cancer
