Chemotherapy antineoplastic agents

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. 

Cancer treatment is a multimodality treatment, i.e., surgery is combined with radiotherapy and antineoplastic chemotherapy. The latter treatment mode is used mainly for cancers which have disseminated. Different forms of cancer differ in their sensitivity to chemotherapy with antineoplastic agents. The most responsive include lymphomas, leukemias, choriocarcinoma and testicular carcinoma, while solid tumors such as colorectal, pancreatic and squamous cell bronchial carcinomas generally show a poor response. The clinical use of antineoplastic agents is characterized by the following principles. 

Patients receiving cytotoxic chemotherapy very often need concomitant administrating of antiemetic therapy. Such protocols will start well in advance of administering the cytotoxic, and last for a reasonable time with regard to pharmacokinetics of the antineoplastic agent. In addition, side effects of antineoplastic therapy are made better tolerable by supportive care. 

Neurotoxicity is rarely dose hmiting in cancer chemotherapy. The only antineoplastic agent that has a dose-limiting neurotoxicity is... 

Originally developed as part of a large-scale effort headed by the United States National Cancer Institute to investigate chemotherapeutic agents from natural sources, paclitaxel was approved by the FDA in 1992 as an antineoplastic agent to treat metastatic ovarian cancer after failure of first-line or subsequent chemotherapy (37). Further studies demonstrated efficacy in other solid tumors (38). In addition, paclitaxel was shown to inhibit T- and B-cell proliferation when tested for transplant-rejection application (39,40) and has demonstrated inhibition of matrix-metalloproteinase synthesis in studies conducted to test its utility for rheumatoid arthritis (41). 

Ranuzzi M, Taddei A. Neurotoxicity of antineoplastic agents in chemotherapy. Nuova Riv Neurol 1996 6 55-63. 

Both the benefits and toxicides of mechlorethamine stimulated a worldwide search for new antineoplastic agents. In the United States, the National Cancer Institute (NCI) had been established in 1937 and was already empirically studying plant extracts for anticancer activity. In 1955, the NCI established the Cancer Chemotherapy National Service Center to systematically screen drugs in vitro and in vivo. NSC numbers were assigned to each new drug screened and the number now exceeds 720 000. Over the past half century, a growing understanding... 

A variety of platinum (Pt)-containing antineoplastic agents are used in chemotherapy, typified by cisplatin cts-dichlorodiammineplatinum dihydrate) All of diese compounds have some nephrotoxicity that is related to the concentration of Pt circulating in the blood. Although it is not common to measure Pt concentrations in all patients receiving cisplatin therapy, quantification of Pt concentrations in patients with reduced renal function can help identify whether the Pt is the cause of the compromised renal function. Peak serum concentrations greater than... 

Release of 5-Fluorouracil. 5-Fluorouradl (5-FU) is a well known antineoplastic agent that finds applications in cancer chemotherapy [40] and in the prevention of fibroblast proliferation following glaucoma filtration surgery [14]. 

One of the goals of cancer chemotherapy is to enhance the efficacy of antineoplastic agents and at the same time protect the nonmalignant tissues using chemoprotective... 

Paclitaxel, an antineoplastic agent, is used in the treatment of metastatic ovarian cancer after failure of first-line or subsequent chemotherapy (135 mg/m IV over 24 hours q. 3 weeks) and breast carcinoma after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy (175 mg/m IV over 3 hours q. 3 weeks). 

Pteridines are also used as pharmaceuticals. Triamterene 15 is a diuretic that promotes excretion of Na" and retains K+. The folic acid antagonist methotrexate 16 (amethopterin) is of considerable importance as an antineoplastic agent in cancer chemotherapy. 

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