Antineoplastic Drugs
What you need to know?
Each family moa, examples, certain adverse effects, specificity (can differentiate between
normal) or cell phase specific
Cancer:
Tumor:
h
Definition: Abnormal growth of cells → Loss of Machinery control of Growth
(Misbalance between proliferation and apoptosis)
es
Can be Benign or Malignant
Have the ability to invade local tissue (invasion):
w
Stage 1 or Stage 2
ai
Ability to invade the blood vessels and go to other
sites (Metastasis)
hr
Four main stages of Cancer:
Ik
1. Stage 0: in situ
2. Stage 1: epithelial involvement
3. Stage 2: invasion into muscular involvement
h
4. Stage 3: invosion into lymph nodes
ee
5. Stage 4: Invasion into distant organs
m
Time of Diagnosis: Most people come in late stages
Sa
Importance of Cancer Treatment:
Cancer is considered as the second main cause of death (CVS disease number one
cause)
In males the most common type is prostate cancer→ BUT most common
ik
death-causing cancer is lung cancer.
al
In females the most common type is breast cancer while the most common
death-causing cancer is lung cancer
M
Hallmarks of cancer:
r.
1. Abnormal Growth (proliferation without growth
signals and no apoptosis)
D
2. Invasion and Metastasis
3. Angiogenesis: Process of forming new blood
vessels → Cells after growing will be away
from blood vessels → Hypoxic → Release
“HIF” (hypoxia inducible factor) → VEGF will
be released from cancer cells and bind to
VEGFR in Endothelial Cells→ Angiogenisis
1
, 4. Evasion of Immune System
5. Inflammation → Peptic Ulcer → Caused by chronic infection from H. Pylori → Chronic
Inflammation → Dysplasia → Adenocarcinoma
Treatment Modalities → Depending on Stage:
1. Localized (Stage 1 and Stage 2) → Surgical
Removal and Radiotherapy
2. Late Stage → Surgery is not a choice → Use
h
systemic Treatment → Chemotherapy → Stage 3
es
and 4 AND SOME cases of stage 2 (High risk
patients , family history)
w
3. Stage 4→ We can add immunotherapy (MAB) →
Drugs that target certain receptors (Very expensive)
ai
Anti-cancer drugs are divided into two main types:
hr
1. Chemotherapy “Conventional Cytotoxic Drugs”
Ik
original ones used since a long period of time
VERY EFFECTIVE BUT NOT SPECIFIC → cause lethal cytotoxic effects
h
since they target DNA in Proliferating Cells → Because cancer cells are highly
ee
proliferating → Reducing size
Not all cells are proliferating (Not in S phase) → Will not be affected by
chemotherapy (One of the major problems of conventional Chemotherapy)
m
Side Effects will be mainly in highly proliferating tissues → hair follicles
(Alopecia) → Bone marrow suppression → GI Epitheliam (Ulceration)
Sa
2. Molecular Chemotherapeutics: (More specific and less adverse effects)
ik
Tyrosine kinase inhibitors
al
MAB
Have a certain target and receptor → only present in cancer cells (or are in
M
high levels in cancer cells)
Goals of chemotherapy:
r.
D
1. Curative Goal: Eradicate all tumor cells → Not achievable (Rarely)
2. Control Goal: Stop progression and invasion of highly proliferating cells → To not
advance
3. Palliative Goal: Manage the symptoms → Advanced stages of cancer
2
What you need to know?
Each family moa, examples, certain adverse effects, specificity (can differentiate between
normal) or cell phase specific
Cancer:
Tumor:
h
Definition: Abnormal growth of cells → Loss of Machinery control of Growth
(Misbalance between proliferation and apoptosis)
es
Can be Benign or Malignant
Have the ability to invade local tissue (invasion):
w
Stage 1 or Stage 2
ai
Ability to invade the blood vessels and go to other
sites (Metastasis)
hr
Four main stages of Cancer:
Ik
1. Stage 0: in situ
2. Stage 1: epithelial involvement
3. Stage 2: invasion into muscular involvement
h
4. Stage 3: invosion into lymph nodes
ee
5. Stage 4: Invasion into distant organs
m
Time of Diagnosis: Most people come in late stages
Sa
Importance of Cancer Treatment:
Cancer is considered as the second main cause of death (CVS disease number one
cause)
In males the most common type is prostate cancer→ BUT most common
ik
death-causing cancer is lung cancer.
al
In females the most common type is breast cancer while the most common
death-causing cancer is lung cancer
M
Hallmarks of cancer:
r.
1. Abnormal Growth (proliferation without growth
signals and no apoptosis)
D
2. Invasion and Metastasis
3. Angiogenesis: Process of forming new blood
vessels → Cells after growing will be away
from blood vessels → Hypoxic → Release
“HIF” (hypoxia inducible factor) → VEGF will
be released from cancer cells and bind to
VEGFR in Endothelial Cells→ Angiogenisis
1
, 4. Evasion of Immune System
5. Inflammation → Peptic Ulcer → Caused by chronic infection from H. Pylori → Chronic
Inflammation → Dysplasia → Adenocarcinoma
Treatment Modalities → Depending on Stage:
1. Localized (Stage 1 and Stage 2) → Surgical
Removal and Radiotherapy
2. Late Stage → Surgery is not a choice → Use
h
systemic Treatment → Chemotherapy → Stage 3
es
and 4 AND SOME cases of stage 2 (High risk
patients , family history)
w
3. Stage 4→ We can add immunotherapy (MAB) →
Drugs that target certain receptors (Very expensive)
ai
Anti-cancer drugs are divided into two main types:
hr
1. Chemotherapy “Conventional Cytotoxic Drugs”
Ik
original ones used since a long period of time
VERY EFFECTIVE BUT NOT SPECIFIC → cause lethal cytotoxic effects
h
since they target DNA in Proliferating Cells → Because cancer cells are highly
ee
proliferating → Reducing size
Not all cells are proliferating (Not in S phase) → Will not be affected by
chemotherapy (One of the major problems of conventional Chemotherapy)
m
Side Effects will be mainly in highly proliferating tissues → hair follicles
(Alopecia) → Bone marrow suppression → GI Epitheliam (Ulceration)
Sa
2. Molecular Chemotherapeutics: (More specific and less adverse effects)
ik
Tyrosine kinase inhibitors
al
MAB
Have a certain target and receptor → only present in cancer cells (or are in
M
high levels in cancer cells)
Goals of chemotherapy:
r.
D
1. Curative Goal: Eradicate all tumor cells → Not achievable (Rarely)
2. Control Goal: Stop progression and invasion of highly proliferating cells → To not
advance
3. Palliative Goal: Manage the symptoms → Advanced stages of cancer
2
