Cancer chemotherapy agents

Gelman RS et al. Actual versus ideal weight in the calculation of surface area Effects on dose of 11 chemotherapy agents. Cancer Treat Rep 1987 71 907-911. 

Fluorinated Heterocyclic Compounds. HeterocycHc compounds containing the CF group are prepared by methods similar to those used in the fluorination of aHphatic compounds. The direct action of fluorine on uracil yields the cancer chemotherapy agent, 5-fluorouracil [51-21-8] as one special example of a selective fluorination on a commercial scale (25). 

Aziridines occur naturally in the form of mitomycins (Table 3), which have antibiotic activity (1,449). Mytomycin C is used clinically as one of the most effective agents in the chemotherapy of cancer (450). 

Cancer or neoplastic disease is a genomic disorder of the body s own cells which start to proliferate and metastasize in an uncontrolled fashion that is ultimately detrimental to the individual. Antineoplastic agents are used in conjunction with surgery and radiotherapy to restrain that growth with curative or palliative intention. The domain of antineoplastic chemotherapy is cancer that is disseminated and therefore not amenable to local treatment modalities such as surgery and radiotherapy. 

Carcinogenic agents include chemicals in the environment, such as aniline and benzene, which are associated with the development of bladder cancer and leukemia, respectively. Environmental factors, such as excessive sun exposure, also may result in cancer. Viruses, including the human papilloma virus and hepatitis B, maybe associated with the development of cancer. Some of the chemotherapy agents cause secondary cancers after therapy has been completed. Numerous factors may contribute to the development of cancer. 

Cancer chemotherapy and the treatment of cancers are analogous to anti-infectives and the treatment of infections. Cancer cells may be sensitive to certain chemotherapy agents, but then with repeated exposure, the cells become resistant to treatment. The resistant cells then grow and multiply. While tumors may be tested for chemotherapy sensitivity, this area is still developing. Today, tumor sensitivity can demonstrate tumor resistance so that needless exposure to an inadequate therapy and its toxicity can be avoided. 

Tumor cells may become resistant when genetic changes occur during cell proliferation. Resistant cancer cells with the mdr-1 gene may possess a membrane-associated protein, p-glycoprotein, that facilitates efflux of chemotherapy agents out of the cells. Numerous attempts at blocking this efflux pump have been unsuccessful. 

Chemotherapy of cancer started in the early 1940s when nitrogen mustard was administered to patients with lymphoma. Since then, numerous agents have been developed for the treatment of different cancers. 

Many chemotherapy agents have significant organ toxicities that preclude using larger and larger doses to treat the cancer. The doses of chemotherapy must be spaced out to allow the patient to recover from the toxicity of the chemotherapy each... 

Another important consideration for treatment of cancers is reimbursement by third-party payors for off-label use of chemotherapy agents because of the high expense. The American Association of Cancer Centers (www.accc-cancer.org) provides... 

TABLE 91-2. Summary of Chemotherapy Agents Used for First-Line Treatment of Advanced Ovarian Cancer Mechanism of action of first-line agents ... 

TABLE 91-3. Summary of Chemotherapy Agents Used for Second-Line Treatment of Progressive and Recurrent Platinum-Resistant Ovarian Cancer... 

Provide appropriate patient education on respective chemotherapy agents that will be given for treatment of recurrent ovarian cancer. 

Colchicine (a drug used in treatment of gout) and vinblastine (a cancer chemotherapy agent) may decrease liver uptake of americium. In rats that received an intraperitoneal injection of either colchicine and vinblastine prior to an intravenous or intramuscular injection of americium citrate, liver uptake of americium was lower, relative to controls, and kidney and skeletal americium uptake were higher (Seidel 1984, 1985). The effect is thought to involve disruption of hepatic microtubule formation, which is critical to the formation and intracellular processing of lysosomes, the initial site of accumulation of americium in the liver. 

Taxol (K. C. Nicolaou) a potent cancer chemotherapy agent. 

Cyclophosphamide (Cytotoxin) Alkylating agent cancer chemotherapy transplant rejection rheumatoid arthritis Decreased Ts cells, B cells, and NK cells... 

C36 263 caldum 74 calibration runs 164 calixarenes 133 cancer chemotherapy agents 9... 

Ciomei M, Croci V, Ciavolella A, Ballinari D, Pesenti E. Antitumor efficacy of edotecarin as a single agent and in combination with chemotherapy agents in a xenograft model. Clin. Cancer Res. 2006 May 1 12(9) 2856-61. 

Chemotherapy and radiation therapy play an important role in the management of colorectal carcinoma. Significant improvements in tumor control and overall survival have been demonstrated with the use of combined-modality therapy in several randomized clinical trials performed over the past 25 yr. This chapter reviews the role of adjuvant chemotherapy and radiation therapy for colon and rectal cancer. Issues surrounding chemoradiation for rectal cancer, including sphincter preservation, total mesorectal excision, local excision, and newer chemotherapy agents, are also discussed. 

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