CHEMO DRUGS CLASSIFICATION
Classification of Chemo Drugs –
- Alkylating drugs
- Plant Alkaloids
- Antumor Antibiotics
- Antimetbolites
- Topoisomerase Inhibitors
- Hormone Therapy
- Monoclonal Antibodies and Other Targeted Therapies
- Misc Antineoplastics
Alkylating agents
- Mustard gas derivatives Mechlorethamine, Cyclophosphamide( Endoxan), Chlorambucil( Leukeran), Melphalan( Alkeran), and Ifosfamide.
- Ethylenimines Thiotepa and Hexamethylmelamine.
- Alkylsulfonates Busulfan.
- Hydrazines and Triazines Altretamine, Procarbazine, Dacarbazine and Temozolomide.
- Nitrosureas Carmustine( BCNU, BiCNU), Lomustine( CCNU, CeeNU) Semustine( Methyl-CCNU) and Streptozocin.
- Metal salts Carboplatin, Cisplatin, and Oxaliplatin
Nitrosureas are unique because, unlike most types of chemo treatments, they can cross the blood-brain barrier. They can be useful in treating brain tumors.
- Plant Alkaloids
The plant alkaloids are cell-cycle specific i.e. they attack the cells during various phases of division.
Plant alkaloids are chemotherapy treatments derived made from certain types of plants. The vinca alkaloids are made from the periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents. The podophyllotoxins are derived from the May apple plant. Camptothecan analogs are derived from the Asian “Happy Tree” (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors, which are used in certain types of chemotherapy.
Vinca alkaloids: Vincristine, Vinblastine and Vinorelbine.
Taxanes: Paclitaxel and Docetaxel.
Podophyllotoxins: Etoposide and Teniposide.
Camptothecan analogs: Irinotecan and Topotecan.
- Antitumor Antibiotics
Antitumor antibiotics are chemo treatments made from natural products produced by species of the soil fungus Streptomyces. These drugs act during multiple phases of the cell cycle and are considered cell-cycle specific. There are several types of antitumor antibiotics:
Anthracyclines: Doxorubicin, Daunorubicin, Epirubicin, Mitoxantrone, and Idarubicin.
Chromomycins: Dactinomycin and Plicamycin.
Miscellaneous: Mitomycin and Bleomycin.
- Antimetabolites
Antimetabolites are types of chemotherapy treatments that are very similar to normal substances within the cell. When the cells incorporate these substances into the cellular metabolism, they are unable to divide. Antimetabolites are cell-cycle specific. They attack cells at very specific phases in the cycle. Antimetabolites are classified according to the substances with which they interfere.
Folic acid antagonist: Methotrexate.
Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine, Capecitabine, and Gemcitabine.
Purine antagonist: 6-Mercaptopurine and 6-Thioguanine.
Adenosine deaminase inhibitor: Cladribine, Fludarabine, Nelarabine and Pentostatin.
- Topoisomerase inhibitors
Toposiomerase inhibitors are types of chemotherapy drugs that interfere with the action of topoisomerase enzymes (topoisomerase I and II). During the process of chemo treatments, topoisomerase enzymes control the manipulation of the structure of DNA necessary for replication.
Topoisomerase I inhibitors: Ironotecan, topotecan
Topoisomerase II inhibitors: Amsacrine, etoposide, etoposide phosphate, teniposide
Hormone Therapy – Aromatase Inhibitors, Ihrh Agonists, Antiandrogens – Cancer
Hormones are chemical substances produced by glands in the body, which enter the bloodstream and cause effects in other tissues. For example, the hormone testosterone is made in the testicles and is responsible for male characteristics such as deepening voice and increased body hair. The use of hormone therapy to treat cancer is based on the observation that receptors for specific hormones that are needed for cell growth are on the surface of some tumor cells. Hormone therapy can work by stopping the production of a certain hormone, blocking hormone receptors, or substituting chemically similar agents for the active hormone, which cannot be used by the tumor cell. The different hormone therapy types are categorized by their function and/or the type of hormone that is effected.
Hormone Therapy:
- Adrenal steroid inhibitors : This type of hormone therapy interferes with the hormones produced by the adrenal gland. The adrenal glands are located on top of the kidneys. The outer portion of the adrenal gland (the adrenal cortex) produces hormones called corticosteroids. When these corticosteroids are blocked from being made, they are not able to signal the body to produce other hormones such as estrogen, androgens, glucocorticoids, and mineralocorticoids. The resulting decrease of estrogens and androgens interferes with the stimulation of cancer growth in tumors that are influenced by these hormones.
Aminoglutethimide, mitotane
- Androgens: Androgens are hormones such as testosterone and androsterone that produce or stimulate the development of male characteristics. In women, these hormones can be converted into estrogen. Androgens as cancer therapy are used to oppose the activity of estrogen, thereby slowing the growth of cancer.
Fluoxymesterone, testosterone, testolactone
3.Antiandrogens: Antiandrogens are substances that block the effects of testosterone. Cancer of the prostate depends on the male hormone testosterone for its growth. If the amount of testosterone is reduced it is possible to slow down or shrink the cancer.
Bicalutamide, flutamide, nilutamide
- Antiestrogens: Antiestrogens bind to estrogen receptor site on cancer cells thus blocking estrogen from going into the cancer cell. This interferes with cell growth and eventually leads to cell death.
Tamoxifen, toremifene
- Aromatase inhibitors: Aromatase inhibitors block the enzyme aromatase (found in the body’s muscle, skin, breast and fat), which is used to convert androgens (hormones produced by the adrenal glands) into estrogen. In the absence of estrogen, tumors dependent on this hormone for growth will shrink.
Anastrazole, exemestane, letrozole
- Estrogens: Estrogens are female hormone used to compete for androgen receptor sites, which decreases the influence of androgens (testosterone and androsterone) on prostate cancer.
DES(diethylstilbestrol), estradiol(estrace), premarin
- LHRH agonists(Lutenizing hormone-releasing hormone): LHRH agonists work by telling the pituitary gland located in the brain to stop producing leutinizing hormone, which (in men) stimulates the testicles to release testosterone and (in women) stimulates the ovaries to release estrogen. The drug does not have a direct effect on the cancer, only on the testicles or ovaries. The resulting lack of testosterone (in men) and estrogen (in women) interferes with stimulating cell growth in testosterone or estrogen dependent cancer cells.
Goserelin acetate, leuprolide acetate, triptorelin pamoate
- Progestational agent: Progestational agents are a man made form of the female hormone progesterone.It has anti-estrogen effects. Medroxyprogesterone acetate, hydroxyprogesterone caproate, megestrol, progestins
- Selective Estrogen Receptor Modulators (SERMs): The term “SERMs” describes drugs that act like estrogen in some organs and as an anti-estrogen in others. For example: Raloxifene acts like estrogen to prevent bone loss and improve lipid profiles (decreases total and LDL cholesterol but does not raise triglycerides), but it has the potential to block some estrogen effects such as those that lead to breast cancer and uterine cancer.
Raloxifene
Other chemicals, such as amifostine, dexrazoxane, and mesna, are known as chemoprotective agents. These drugs may be used with certain chemotherapy programs to reduce or minimize the effects of chemotherapy on the body.
