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Oncology Drugs

generic nameMOAImportant informationUses:Toxicites
Ifosfamide Akylating agent-Form covalent bond w/ cancer DNA, which prevents unwinding and replication of DNA. Cell cycle non-specific CNS toxicites caused by chloroacetaldehyde metabolite-D/C therapy sarcomas, lymphoma, testicular, bladder, head and neck, cervical and lung cancers Myelosuppresion(DLT), N/V, alopecia, Amenorrhea, infertility, Hemorrhagic cystist(must use MESNA), nephrotoxicity, cardiotoxicity, CNS toxicites
oxaliplatin Akylating agent-Form covalent bond w/ cancer DNA, which prevents unwinding and replication of DNA. Cell cycle non-specific warn them about chest numbness colorectal and esophageal cancers mild myelosuppression, N/V, diarrhea, neuropathy(DLT)(can't feel breathing and intolerant to cold), nephrotoxicity uncommon
Cisplatin Akylating agent-Form covalent bond w/ cancer DNA, which prevents unwinding and replication of DNA. Cell cycle non-specific have to give plenty of fluids + mannitol and antiemetics lung, ovarian, testis, bladder, head and neck, lymphomas, and esophageal cancers mild myelosuppresion, severe N/V, nephrotoxicity(DLT), severe decrease in Mg and K, Neuropathy, ototoxicity
Carboplatin Akylating agent-Form covalent bond w/ cancer DNA, which prevents unwinding and replication of DNA. Cell cycle non-specific use calvert equation to dose=AUC x (GFR + 25) lung, ovarian, testes, bladder, breat, endometrial, relapse leukemias, and head and neck cancers. more myelosuppresion(DLT) (thrombocytopenia), less nephrotoxicity, neuropathy, ototoxicity, and N/V
Methotrexate Antifolate Antimetabolite agent-inhibit dihydrofolate reductaseactive in S phase hydration w/ urinary alkalinization, antiemeticsLeucovorin is a rescue when a high dose is given. leukemia, lymphoma, osteosarcoma, breast, head and neck and bladder cancers myelosuppresion, mucositis, N/V/D, hepatotoxicity, nephrotoxicity
Pemetrexed Antifolate Antimetabolite agents-inhibits dihydrofolate reductase and thymidylate synthase must be given w/ folic acid and Vit. B12 to reduce myelosuppression mesothelioma, non-small cell lung, colorectal, breast, pancreatic, and bladder cancers myelosuppression(DLT), N/V, mucositis, skin rash
5-Fluorouracil 5-Fluoropyrimidine Antimetabolite agent-incorporated into DNA as a false base pair. Inhibits TS which results in thymidylate deficiency. Prevents DNA repair and synthesis Continous-D/mucositis, Hand/Foot, Vasospastic anginabolus-BM suppresion, metallic tasteleucovorin enhances the drug. breast, colorectal, gastric, pancreatic, ovarain, head and neck and basal cell skin(topical) N/V, excessive lacrimation, somnolence, photosensitiviy, dry skin
Capecitabine 5-Fluoropyrimidine Antimetabolite agent-incorporated into DNA as a false base pair. Inhibits TS which results in thymidylate deficiency. Prevents DNA repair and synthesis oral prodrug of 5-FU, 3 step enzymatic process that occurs only in tumorblack box: with warfarin colorectal and metastic breast cancer N/V, mucositis, Diarrhea, HAND AND FOOT SYNDROME
cytarabine Cytidine Antimetabolite agent-ARa-C is triphosphorylated to ara-CTp which is incorporated into the DNA and halts strand elongation/repair high-dose: Cerebellar toxicity(ataxia, nystagmus, slurred speech, tremor)5 days after tx and chemical conjunctivitishand and foot rare acute & chronic leukemia, NHL, leptomeningeal carcinomatosis depends on dose and schedule: myelosuppression, N/V, Diarrhea, Mucositis, hepatic dysfunction
Gemcitabine Cytidine Antimetabolite agent-ARa-C is triphosphorylated to ara-CTp which is incorporated into the DNA and halts strand elongation/repair soft tissue sarcomas, pancreatic, lung, breast, ovarian, and bladder cancers myelosuppression(DLT), flu-like, asthenia, increased transaminases
vincristine vinca alkaloids-bind to tubulin, which inhibits polymerization,which is needed to form mitotic spindle. M phase specific dose empirically capped at 2mg due to neurotoxicity Vesicant leukemia, lymphoma, Wilm's tumor, neuroblastoma, brain, sarcoma neuropathy(DLT), constipation, SIADH, mucositis, decreased myelosuppression
vinblastine vinca alkaloids-bind to tubulin, which inhibits polymerizationwhich is needed to form mitotic spindle,. M phase specific causes more myelosuppression than neuropathyvesciant testicular cancer, lymphoma, kaposi's sarcoma, neuroblastoma myelosuppression(DLT), neuropathy, constipation, SIADH, mucositis
Vinorelbine vinca alkaloids-bind to tubulin, which inhibits polymerization, which is needed to form mitotic spindle. M phase specific Vesicant NSCLC, breast More myelosuppresion than Vinblastine(DLT), neuropathy, SIADH, mucositis
Doxorubicin Anthracycline agent-Topoisomerase II inhibitor, DNA intercalation, inhibits DNA dependent Rna polymerase, free radical generation extravasation(vesicant) breast, lung, gastric, bladder, thyroid, and ovarain cancers, leukemia, lymphoma, multiple myeloma, neuroblastoma, and soft tissue sarcoma myelosuppression(DLT),N/V, mucositis & diarrhea, alopecia, hyperpigmentation of nails, rare skin rash, urticaria, cardiotoxicity, red/orange urine
Daunorubicin Anthracycline agent-Topoisomerase II inhibitor, DNA intercalation, inhibits DNA dependent Rna polymerase, free radical generation drug is a red/orange colorvesicant acute myeloid leukemia, acute lymphoid leukemia myelosuppression(DLT),N/V, mucositis & diarrhea, alopecia, hyperpigmentation of nails, rare skin rash, urticaria, cardiotoxicity, red/orange urine
idarubicin Anthracycline agent-Topoisomerase II inhibitor, DNA intercalation, inhibits DNA dependent Rna polymerase, free radical generation drug is a red/orange colorvesciant acute myeloid leukemia myelosuppression(DLT),N/V, mucositis & diarrhea, alopecia, hyperpigmentation of nails, rare skin rash, urticaria, cardiotoxicity, red/orange urine
liposomal doxorubicin Anthracycline agent-Topoisomerase II inhibitor, DNA intercalation, inhibits DNA dependent Rna polymerase, free radical generation drug is an irritant ovarian cancer, breast cancer, mutiple myeloma myelosuppression, N/V, mucositis, hand-foot, infusion related reactions
irinotecan Inhibit topoisomerase I which results in DNA single stranded breaks-S phase specific acute and delayed diarrhea colorectal, lung cancer myelosuppression(DLT), N/V mucositis, alopecia, Diarrhea(DLT), cholinergic syndrome
topotecan Topoisomerase II inhibitor by forming ternary complexes w/ it which results in Double stranded DNA breaks-G2 phase specific lymphoma, ovarian, cervical, testicular, gastric, and lung cancers myelosuppression(DLT), mucositis, Diarrhea(mild), elevated transaminases
etoposide Vp-16 Topoisomerase II inhibitor by forming ternary complexes w/ it which results in Double stranded DNA breaks-G2 phase specific 50mg capsules are available-bio availability is 50% testicular cancer, acute leukemia, lymphoma, lung cancer, ovarian cancer myelosuppression(DLT), N/V, alopecia, mucositis, secondary AML, infusion related reactions
Paclitaxel Taxane agent-bind tubulin creating dysfunctional microtubules resistant to depolymerization. M phase specific Give dexamethasone, H1 and H2 antagonist to treat hypersensitivities breast, ovarian, lung,bladder,prostate, esophageal, head and neck disorders, Kaposi's sarcoma myelosuppresion(DLT), mucositis, alopecia, hypersensitivity reactions(cremophor), neuropathy, myalgias, arthralgias, hepatotoxicity, EKG abnormalities
Docetaxel Taxane agent-bind tubulin creating dysfunctional microtubules resistant to depolymerization. M phase specific given w/ 3 days of dexamethasone for prophylaxis of edema & prevent infusion reactions breast cancer, ovarian cancer, NSCLC, prostate cancer myelosuppression, mucositis, alopecia, neuropathy, peripheral edema, myalgias, fatigue, hepatoxicity, infusion related reactions
albumin-bound paclitaxel Taxane agent-bind tubulin creating dysfunctional microtubules resistant to depolymerization. M phase specific no El Cremophor, decreased risk of reactions. NO need for traditional premedications produced via nanotechnology breast cancer myelosuppression, alopecia, neuropathy, myalgias, hepatoxicity, EKG abnormalities
Ixabepilone Epothilone agent-resembles taxanes-bind tubulin creating dysfunctional microtubules resistant to depolymerization. M phase specific pre-meds H1 and H2 antagonist metastatic breast cancer who have progressed on anthracyclines and taxanes
Bevacizumab HUMANIZED-monoclonal antibody-vascular endothelial growth factor, which initiates angiogenesis(forms new blood vessels) documented improvement in survival w/ chemo in metastatic colon and breast cancers colon, NSCLC, breast, ovarian bleeding, thrombosis, HTN, infusion reactions, nephrotic syndrome, impaired wound healing, Gi perforations
traztuzumab HUMANIZED-monoclonal antibody-her-2-neu, which is expressed on breast carcinomas benefit as a single agent and in combination w/ chemo Her2/neu overexpressing breast cancer infusion reactions, cardiomyopathy(w/ anthracyclines), diarrhea
Rituximab CHIMERIC-monoclonal antibody-B-cell surface marker CD20, which is against lymphoma cells active in both indolent and agressive NHL, start infusion slow and then increase NHL,CLL, immunologic diseases(ITP) infusion reactions, mild myelosuppression
Cetuximab CHIMERIC- monoclonal antibody-epidermal growth factor receptor used as single or combo therapy w/ irinotecan in colorectal cancer colorectal, head and neck infusion reactions, aceneform rash, diarrhea, asthenia, paronychia, hypmagnesemia
Panitumumab FULLY HUMAN-monoclonal antibody--directed against Epidermal growth factor receptor used only as a single agent colorectal cancer decreased infusion reactions, acneform rash, diarrhea, asthenia, paronychia, hypomagnesemia
Imatinib Tyrosine Kinase Inhibitor-inhibits Bcr-Abl tyrosine kinase,which is product of philadelphia chromosome in CML many drug interaction-CYP3A4 CML, ALL(Ph+), GIST myelosuppression, nausea, diarrhea, edema, rash, hepatotoxicity
Erlotinib Tyrosine Kinase Inhibitor-epidermal growth factor receptor such as in lung cancer mild benefit in patients who have failed standard treatment lung cancer fatigue, diarrhea, acneform rash, nausea
Lapatinib Tyrosine Kinase Inhibitor-Inhibits epidermal growth factor receptor (HER1 and HER2/neu-breast carcinomas many drug interactions-CYP3A4 breast cancer fatigue, diarrhea, rash, nausea, hepatotoxicity
Bortezomib Proteosome inhibitor promotes apoptosis relapsed multiple myeloma and relapsed or refractory mantle cell lymphoma thrombocytopenia, fatigue, peripheral neuropathy, neutorpenia, diarrhea
Thalidomide/Lenalidomide not fully understood, Immune modulation?? must register in STEPS program-contraceptions, filled w/in 7 days, 4 weeks at a time multiple myeloma teratogenic, DVT, somnolence, rash, neuropathy, constipation, and dizziness/hypotension
Cyclophosphamide Akylating agent-Form covalent bond w/ cancer DNA, which prevents unwinding and replication of DNA. Cell cycle non-specific metabolized to active species. drug increases anticoagulation effect and decreases digoxin plasma levels. Phenobarbital and phenytoin increase rate of drug metabolism to toxic metabolites leukemia, lymphoma, multiple myeloma, sarcomas, bone, breast and ovarian cancers myelosuppresion(DLT), N/V, alopecia, Amenorrhea, SIADH, Hemorrhagic cystitis(acrolein damages bladder), Cardiotoxicity
Created by: lmiklavc