Anticancer Flashcards
log-kill hypothesis
cancer drugs kill constant percentage of cells, not a constant number
growth fraction
cancer drugs work better on high growth fraction tumors
- also affect high growth fraction normal cells
S phase anti-cancer drugs
cytarabine, 6-MP, 6-TG, 5-FU, methotrexate, hydroxyurea, irinotecan, etoposide
G2 phase anti-cancer drugs
bleomycin
M phase anti-cancer drugs
vinblastine, vincristine, paclitaxel
G0 phase anti-cancer drugs
alkylating agents, antitumor Abx, nitrosureas
Cyclophosphamide
- MOA
- Use
- SE
- alkylating agent–>attack guanine 7–>dysfunctional DNA
- NHL, ovarian, breast, neuroblastoma
- BMS, hemorrhagic cystitis (mesna is protective)
Cisplatin
- MOA
- Use
- SE
- alkylating agent–>crosslink DNA
- testicular, ovarian, bladder, lung
- nephrotoxic (use amifostine) and neurotoxic
procarbazine
- MOA
- Use
- SE
- alkylating agent
- Hodgkin
- BMS, leukemogenic
Doxorubicin
- MOA
- Use
- SE
- intercalator–>forms free rad–>inhib topoisom
- Hodgkin, breast, lung, ovarian
- BMS, delayed CHF (use dexrazoxane)
methotrexate
- MOA
- Use
- SE
- antimetabolite (inhib S phase)
- leukemia, lymphoma, breast, RA, psoriasis
- BMS, leucovorin
5-FU and Capecitabine
- MOA
- Use
- SE
- pyrimidine anti-metabolite
- breast, ovarian, head and neck, basal cell, colorectal
- BMS
6-MU
- MOA
- Use
- SE
- purine antimetabolite
- ALL, immsupp
- BMS
bleomycin
- MOA
- Use
- SE
- complex with O2–>DNA strand scission
- Hodgkin, testicular, head and neck, skin
- pneumonitis, pulmonary fibrosis
vinblastine and vincristine
- MOA
- Use
- SE
- MT polymerization inhibitors (M phase)
- Hodgkin, testicular, Kaposi
- Hodgkin, leukemia, Wilms
- BMS, neurotoxic
ATRA (all-trans retinoic acid
- MOA
- Use
- SE
- differentiating agent–>promotes differentiation of promyelocytes
- AML, M3
- differentiation syndrome with resp distress, pleural and pericardial effusion, CNS symptoms
Anticancer toxicity
- renal
- pulmonary
- cardiac
- neurologic
- immunosuppressive
- other (hemorrhagic cystitis, leukemia, pancreatitis)
- cisplatin, methotrexate
- bleomycin, busulfan, procarbazine
- doxorubicin, daunorubicin
- vincristine, cisplatin
- cyclophosphamide, metotrexate
- cyclophosphamide; procarbazine; asparaginase
Cytokines in anti-cancer treatment
help counter SE
IL-2 (aldesleukin)
increased lymphocyte differentiation and NK
- use in RCC and metastatic melanoma
IL-11
increased platelet formation
- used in thrombocytopenia
G-CSF (filgrastim)
increased granulocytes
- use in marrow recovery
GM-CSF (sargramostim)
increase granulocytes and macs
- use in marrow recovery
EPO
use in anemias, esp with renal failure
thrombopoietin
use in thrombocytopenia
