Antineoplastic drugs (antiblastoma drugs) – drugs that disrupt the development of true tumors (cancer, sarcoma, etc.) and hematological malignancies. According to the international anatomical-therapeutic-chemical classification, they belong to the L code “Antineoplastic and immunomodulating agents”.
Cancer treatment is based on the use of three main methods – surgery, radiation therapy and pharmacotherapy, or their various combinations.
Antineoplastic drugs are divided into a number of groups, based on their chemical structure, sources of production, mechanism of action:
- alkylating agents,
- hormone agonists and antagonists,
- alkaloids and other herbal products,
- monoclonal antibodies,
- protein tyrosine kinase inhibitors and others.
More recently, endogenous antitumor compounds have attracted great attention. Shown the effectiveness of interferons and other lymphokines (interleukins – 1 and 2) in some types of tumors.
Along with a specific inhibitory effect on tumors, modern antineoplastic agents act on other tissues and systems of the body, which, on the one hand, causes their unwanted side effects, and on the other hand, allows them to be used in other fields of medicine.
One of the main side effects of anticancer chemotherapy is the inhibition of hematopoiesis, which requires precise regulation of doses and regimen of drugs; it should be borne in mind that the depression of hematopoiesis increases with combination therapy – a combination of drugs with radiation therapy, etc. Nausea, vomiting, loss of appetite, diarrhea are often observed, alopecia and other side effects are possible. Some antitumor antibiotics have cardio (doxorubicin, etc.), nephro-, oto-, hepato- and neurotoxicity. With the use of certain drugs, hyperuricemia may develop. Estrogens, androgens, their analogs and antagonists can cause hormonal disorders.
One of the characteristic features of many anticancer drugs is their immunosuppressive action, accompanied by the development of infectious complications. At the same time, a number of anticancer drugs (methotrexate, cyclophosphamide, cytarabine, etc.) are used as immunosuppressants in autoimmune diseases.
General contraindications to the use of anticancer drugs are severe leuko- and thrombocytopenia, severe cachexia, terminal stages of the disease. The question of their use during pregnancy is decided individually. Usually, due to the danger of teratogenic action, these drugs are not prescribed during pregnancy, as well as during breastfeeding (breastfeeding should be discontinued).
Antineoplastic agents are used only as directed by an oncologist. Depending on the characteristics of the disease and its course, the effectiveness and tolerability of chemotherapy, the prescription regimen, doses, a combination with other drugs, etc. can be changed.
Medicinal methods have been developed to increase the tolerance of anticancer drugs. So, highly effective antiemetics (blockers of serotonin 5-HT3 receptors: ondansetron, tropisetron, granisetron, etc.) can reduce nausea and vomiting, “colony-stimulating factors” (filgrastim, molgramostim, etc.) – to reduce the risk of developing neutropenia.
Below is a list of antineoplastic agents: