CHEMOTHERAPY c.

Alkyl sulfonates (bisulfan)

d.Triazines (decarbazine)
It is a systemic intervention:
e.Ethylenimines (thiotepa)
-disease is widespread
Ex: Cisplatin, Chlorambucil, Cyclophosphamide,
-The risk of undetectable disease is high
Bisulfan
-The tumor cannot be resected and is resistant
to radiation therapy
2.Antimetabolites

GOALS:
Phase-specific, working best in the S phase and
-
having little effect in G0.
-
Subclasses:
- a.Folic Acid Analogues (Methotrexate)
2 Types of Chemotherapy: b.Pyrimidine analogues (5-flourouracil)
c.Cystocine arabinoside (ARA-C)
1. Adjuvant chemotherapy Purine analogues (6-Mercaptopurine)
It is started after initial treatment with either
surgery or radiation therapy. 3.Cytotoxic Antibiotics

2. Neoadjuvant Chemotherapy Derived from various species of

Refers to the preoperative use of and are generally too toxic to be used as
chemotherapy to reduce the bulk and lower the antibacterial agents.
stage of a tumor
Action:
•Disrupt DNA replication and RNA transcription.
(cell cycle non-specific)
•
Classes of Antineoplastic Drugs:

1.Alkylating Agents •

Non-phase specific and basically act on

performed nucleic acids by creating defects in
tumor DNA. They cause cross-linking of DNA Examples:
strands, which can permanently interfere with Actinomycin D
replication and transcription Doxorubucin
Bleomysin
Common adverse effects:
Mithramycin
-acute myelogenous leukemia
Mitomycin-C
-Irreversible infertility
-Nephrotoxicity
4.Plant Alkaloids
-Hemorrhagic cystitis
There are 2 main groups extracted from plant
sources:
5 Subclasses:
a.Nitrogen mustards (mechlorethamine) A. Vinca Alkaloids
b.Nitrosoureas (carmustine) - Vincristine
 - Vinblastin 5.Hirsutism

Action: Phase-specific acting during mitosis. B. Hormone antagonists

They bind to a specific protein that promotes
chromosome migration during mitosis and Work with hormone-binding tumors,
serves as a conduit for neurotransmitter
transport along axons.
Examples:
Toxicity: 1.Tamoxifen – competes with estradiol
a.Depression of deep tendon reflexes receptors in breast tumors.
b.Paresthesias 2.Diethystilbestrol – competes with hormone
Motor weakness receptors in endometrial and prostate tumors
d.Cranial nerve disruptions 3.Anti-androgen (Flutamide) and Luteinizing
e.Paralytic ileus hormone – releasing hormone block
testosterone synthesis in prostate cancer.

6.Miscellaneous Agents
B.Etoposide
Eposin, Etopophos, Vepesid, VP-16
Eg. Cisplatin (Alkylating agent)
An organic drug containing platinum and
Action: It inhibits the enzyme topoisomerase II,
chlorine atoms; most active in the G1 subphase.
which aids in DNA unwinding, and by doing so
causes DNA strands to break.
These platinum complexes react by binding to
Acts in all phases of the cell cycle, causing
and causing cross-linking of DNA,
breaks in DNA and metaphase arrest.

Toxicity: Toxic effect:

1.Bone marrow suppression
2.Nausea and vomiting
3.Hypotension

5. Hormone and Hormone Antagonists

A. Corticosteroids

Phase-specific (G1); acts by binding to specific

intracellular receptors, repressing transcription
of memory RNA

Side Effects:
1.Impaired healing
2.Hyperglycemia
3.Hypertension
4.Osteoporosis