Below is an extensive (but not exhaustive) list of commonly used chemotherapy drugs, grouped by drug class. Each entry includes a brief description of how it works. Keep in mind that exact usage varies by cancer type and individual treatment plan. This information is for educational purposes only and not a substitute for professional medical advice.

1. Alkylating Agents

Alkylating agents damage the DNA of cancer cells, preventing them from multiplying. They add alkyl groups to DNA bases, which leads to breaks in the DNA strands or faulty DNA replication.

  1. Cyclophosphamide (Cytoxan)
    • Often used in lymphomas, leukemias, and multiple myeloma.
    • Can be combined with other drugs to boost effectiveness.
  2. Ifosfamide
    • Similar mechanism to cyclophosphamide, used in some lymphomas and solid tumors.
    • Can cause bladder irritation, so adequate hydration is crucial.
  3. Melphalan
    • Commonly used in multiple myeloma (especially before stem cell transplant).
    • Interferes with DNA synthesis, leading to cell death.
  4. Busulfan
    • Used in chronic myelogenous leukemia (CML) and as part of conditioning regimens before bone marrow transplant.
    • Can reduce blood cell counts significantly.
  5. Bendamustine
    • Has properties of both alkylating agents and antimetabolites.
    • Treats certain types of non-Hodgkin’s lymphoma and chronic lymphocytic leukemia (CLL).

2. Platinum Compounds

Platinum-based drugs form platinum-DNA adducts that distort and damage the cancer cell’s DNA, inhibiting replication.

  1. Cisplatin
    • Used in a variety of cancers, sometimes in combination regimens for lymphomas.
    • Known for kidney toxicity and needs good hydration.
  2. Carboplatin
    • Similar to cisplatin but often with fewer side effects (less kidney toxicity).
    • Used in various cancers, including some blood-related malignancies.
  3. Oxaliplatin
    • Common in colorectal cancer but also used off-label in some hematological settings.
    • Can cause neuropathy (numbness, tingling in hands/feet).

3. Antimetabolites

Antimetabolites mimic the building blocks of DNA or RNA. When cancer cells use these “fake” building blocks, it disrupts their replication and growth.

  1. Methotrexate
    • Interferes with folate metabolism, blocking DNA synthesis.
    • Used in leukemias, lymphomas, and to treat central nervous system (CNS) involvement.
  2. 5-Fluorouracil (5-FU)
    • Prevents proper DNA synthesis by mimicking a component of RNA and DNA.
    • Common in some solid tumors, less so in hematologic cancers but can appear in certain regimens.
  3. Capecitabine
    • An oral prodrug that converts to 5-FU in the body.
    • Often used in solid tumors, sometimes in combination with other therapies.
  4. Cytarabine (Ara-C)
    • Mainstay in acute myeloid leukemia (AML) treatment, also used in some lymphomas.
    • Mimics cytidine, causing DNA chain termination.
  5. Gemcitabine
    • Similar action to cytarabine, but used more in solid tumors; can be part of salvage regimens in lymphomas.

4. Antitumor Antibiotics (Anthracyclines and Others)

These drugs often intercalate (insert) into DNA or generate free radicals that damage DNA strands.

  1. Doxorubicin (Adriamycin)
    • A cornerstone in many lymphoma protocols (e.g., CHOP regimen).
    • Known for potential heart-related side effects.
  2. Epirubicin
    • Similar to doxorubicin, with a slightly different toxicity profile.
    • Less commonly used in hematologic malignancies than doxorubicin, but still an option.
  3. Daunorubicin / Idarubicin
    • Commonly used in acute leukemias (AML and ALL).
    • Works by intercalating into DNA and inhibiting topoisomerase II.
  4. Bleomycin
    • Used in Hodgkin lymphoma (e.g., ABVD regimen).
    • Can cause lung toxicity, requiring regular monitoring.

5. Topoisomerase Inhibitors

These drugs block topoisomerases, enzymes that untangle DNA strands. If DNA can’t be unwound, cells can’t replicate properly.

  1. Etoposide (VP-16)
    • Targets topoisomerase II, often used in lymphomas and leukemias (as well as some solid tumors).
    • Can drop blood counts and lead to secondary leukemias with long-term use.
  2. Irinotecan
    • Primarily for solid tumors (colon, rectal, etc.), but occasionally used in refractory lymphomas.
    • Inhibits topoisomerase I, causing breaks in DNA.

6. Mitotic Inhibitors (Plant Alkaloids)

Mitotic inhibitors block microtubule function, disrupting the division process of cancer cells.

  1. Vincristine / Vinblastine / Vinorelbine (Vinca Alkaloids)
    • Common in lymphoma regimens.
    • Vincristine can cause neuropathy; vinblastine more commonly suppresses bone marrow.
  2. Paclitaxel (Taxol) / Docetaxel
    • More common in solid tumors but can be used in certain lymphomas.
    • Stabilize microtubules, freezing cells in the middle of division.

7. Other Chemotherapeutic Agents

  1. Hydroxyurea
    • Decreases DNA synthesis by blocking the enzyme ribonucleotide reductase.
    • Used to reduce high white blood cell counts in leukemias and myeloproliferative disorders.
  2. Mitomycin C
    • Cross-links DNA, hindering cell division.
    • Typically used in solid tumors but sometimes in salvage lymphoma regimens.
  3. Procarbazine
    • An alkylating-like agent used especially in Hodgkin lymphoma (as part of MOPP regimen).
    • Patients must avoid certain foods (e.g., tyramine) and some medications due to interactions.
  4. L-asparaginase
    • Specifically targets leukemia cells (particularly in ALL) by depleting the amino acid asparagine, which they need to survive.
    • Can cause allergic reactions, pancreas inflammation, and liver issues.

Important Notes for Patients

  • Combination Therapy: Many of these drugs are used in combination to maximize cancer cell kill and reduce resistance.
  • Side Effects: Common issues include fatigue, low blood counts, hair loss, nausea, and risk of infections. Some agents have unique side effects (e.g., neuropathy, heart/lung toxicity).
  • Monitoring: Patients often get regular blood tests (CBC, liver/kidney function) and sometimes imaging or heart/lung function checks.
  • Dose & Duration: Vary widely based on the cancer type, stage, and patient factors like age and overall health.

Disclaimer

This list is intended for general educational purposes and does not replace medical advice. Actual treatment depends on individual factors, including type and stage of cancer, genetic markers, and overall patient health. Always consult an oncology specialist for guidance about your specific treatment plan.

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