Antineoplastic Medications: A
Comprehensive Overview
Antineoplastic Drugs
Cancer treatment includes surgery, radiation therapy, and chemotherapy.
Cancer Drug Nomenclature
Malignant neoplasm is a technical term for cancer. Antineoplastic drugs are
used to treat cancer and are also called cancer drugs, anticancer drugs,
cytotoxic chemotherapy, or just chemotherapy.
Chemotherapy
Chemotherapy is the pharmacologic treatment of cancer using
antineoplastic drugs. These drugs are divided into two groups based on
where they work in the cellular life cycle: cell cycle-nonspecific (CCNS) and
cell cycle-specific (CCS). Some drugs have characteristics of both.
Chemotherapy drugs have a narrow therapeutic index. Combination drug
therapy is usually more effective than single-drug therapy. Drug resistance
is a common issue. Nearly all drugs cause adverse effects, including dose-
limiting adverse effects. Chemotherapy is harmful to all rapidly growing
cells, including cancer cells and healthy normal human cells like hair
follicles, gastrointestinal (GI) tract cells, and bone marrow cells.
Cell Cycle-Specific: Antimetabolites
Antimetabolites include folate (folic acid) analogs like methotrexate (MTX),
pemetrexed, and pralatrexate; pyrimidine analogs like cytarabine (Cytosar-
U, DepoCyt); and purine analogs like mercaptopurine (Purinethol).
Disease-Modifying Antirheumatic Drugs
Methotrexate is an anticancer drug commonly used to treat rheumatoid
arthritis (RA) in much lower doses, administered weekly. Adverse effects
include bone marrow suppression. Folic acid supplements are advised to
lessen the likelihood of adverse effects. It takes 3 to 6 weeks for the onset
of antirheumatic action.
Cell Cycle-Specific: Mitotic Inhibitors
Mitotic inhibitors include vinca alkaloids like vincristine and vinblastine
(Velban), and taxanes like paclitaxel (Taxol, Abraxane).
