What Are Anti-Neoplastic Agents?
Anti-neoplastic agents, also known as anti-cancer drugs, are used to treat malignant or cancerous cell growth. These medicines may be used alone as chemotherapy or along with surgery and radiation therapy. Cancer develops when cells start multiplying abnormally, invade nearby tissues, and spread to distant body parts through blood or lymph.
Types of Cancer
Cancer is grouped based on the type of tissue involved:
- Carcinoma: Begins in the skin or tissues lining internal organs. Includes adenocarcinoma, basal cell carcinoma, squamous cell carcinoma, and transitional cell carcinoma.
- Sarcoma: Arises in bone, cartilage, fat, muscle, and other connective tissues.
- Leukaemia: Originates in bone marrow and causes abnormal blood cell formation.
- Lymphoma and Myeloma: Begins in immune system cells.
- Central Nervous System Tumours: Starts in brain or spinal cord.
Classification of Anti-Neoplastic Agents
Anti-neoplastic drugs are classified into the following categories:
- Alkylating Agents: Mechlorethamine, Cyclophosphamide, Busulfan, Lomustine, Dacarbazine, Melphalan, Ifosfamide.
- Antimetabolites: Methotrexate, 5-Fluorouracil, Cytarabine, Mercaptopurine, Azathioprine.
- Natural Products: Vincristine, Vinblastine, Paclitaxel, Docetaxel, Etoposide, Topotecan, Irinotecan.
- Anti-Cancer Antibiotics: Dactinomycin, Doxorubicin, Bleomycin, Mitomycin C, Mitoxantrone.
- Enzymes: Asparaginase.
- Miscellaneous Agents: Cisplatin, Hydroxyurea, Procarbazine, Carboplatin.
- Hormones and Analogues: Prednisolone, Tamoxifen, Flutamide, Finasteride, Goserelin, Fosfestrol.
- Radioactive Isotopes: Sodium iodide, Sodium phosphate, Radio-gold solution.
Examples of Anti-Neoplastic Agents
Commonly used anti-cancer medicines include:
- Cyclophosphamide
- Busulfan
- Mercaptopurine
- Fluorouracil
- Methotrexate
- Dactinomycin
- Doxorubicin HCl
- Vinblastine Sulphate
- Cisplatin
- Dromostanolone Propionate
Cyclophosphamide
- Cyclophosphamide is an alkylating nitrogen mustard used as an anti-neoplastic and immunosuppressive drug. It is converted in the liver to its active form (aldophosphamide) and forms DNA cross-links that inhibit DNA replication and cause cancer cell death.
- Uses: Treatment of lymphomas, myeloma, leukaemia, neuroblastoma, ovarian and breast cancers, and nephrotic syndrome in children.
- Storage: Store in glass containers, refrigerated below 25°C.
- Formulations: Injection; powder for solution.
- Brands: Procytox, Cytoxan, Endoxan.
Busulfan
- Busulfan is a bifunctional alkylating agent that targets bone marrow. It forms DNA cross-links and suppresses blood cell production.
- Uses: Used with cyclophosphamide before bone marrow transplant for leukemia.
- Storage: Refrigerate at 2°C–8°C.
- Formulations: Tablet, solution.
- Brands: Busulfex, Myleran.
Mercaptopurine
- Mercaptopurine is an antimetabolite that blocks purine synthesis and prevents DNA formation in cancer cells.
- Uses: Maintenance therapy for acute lymphatic leukaemia.
- Storage: Store at room temperature away from moisture.
- Formulations: Tablet, suspension.
- Brands: Purixan, Purinethol.
Fluorouracil (5-FU)
- Fluorouracil is a pyrimidine analogue that blocks thymidylate formation and inhibits DNA and RNA synthesis.
- Uses: Solid tumours including colorectal, breast, pancreatic, and topical treatment of basal cell carcinoma.
- Storage: Stable at 4°C–35°C.
- Formulations: Injection, solution.
- Brands: Actikerall, Carac, Efudex.
Methotrexate
- Methotrexate inhibits dihydrofolate reductase, blocking DNA, RNA, and protein synthesis. It also has immunosuppressive effects.
- Uses: Leukemia, choriocarcinoma, breast cancer; low doses used for psoriasis.
- Storage: Store at 15°C–25°C; protect from light.
- Formulations: Injectable solution; powder.
- Brands: Trexall, Xatmep.
Dactinomycin
- Dactinomycin is an antibiotic that binds DNA and blocks RNA synthesis, preventing protein formation in cancer cells.
- Uses: Wilms’ tumour, rhabdomyosarcoma, Ewing’s sarcoma.
- Storage: Store at 20°C–25°C, protect from light.
- Formulation: Powder for injection.
- Brand: Cosmegen.
Doxorubicin Hydrochloride
- Doxorubicin binds to DNA and inhibits topoisomerase II, blocking DNA repair and causing cancer cell death.
- Uses: Leukemias, breast cancer, sarcomas, bladder cancer.
- Storage: Store at 2°C–8°C.
- Formulations: Powder and solution.
- Brands: Adriamycin, Rubex.
Vinblastine Sulphate
- Vinblastine stops cell division by blocking microtubule formation in cancer cells.
- Uses: Hodgkin’s disease, breast cancer, Kaposi’s sarcoma.
- Storage: Refrigerate at 2°C–8°C.
- Formulations: Injection, powder.
- Brand: Velban.
Cisplatin
- Cisplatin forms cross-links with DNA and prevents repair, leading to cancer cell death.
- Uses: Testicular, ovarian, and bladder cancer.
- Storage: Stable at room temperature in glass or sodium chloride solution.
- Formulations: Injection, solution.
- Brands: Platinol, Platinex.
Dromostanolone Propionate
- Dromostanolone is a synthetic androgen that binds to androgen receptors and alters genetic expression leading to protein synthesis. It shows anti-cancer effects due to hormonal interference.
- Uses: Once used in breast cancer; now withdrawn.
- Storage: Store at 0-4°C for short term or -20°C for long term.
- Formulations: Injection, solution.
- Brands: Drolban, Masteron.
