Chemotherapy drug classifications
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Chemotherapy Drug Classifications: Key Categories and Mechanisms
Chemotherapy drugs are classified based on their mechanisms of action and chemical structure. The main categories include alkylating agents, antimetabolites, anti-tumor antibiotics, topoisomerase inhibitors, mitotic inhibitors, plant derivatives, and corticosteroids. Each class targets cancer cells in different ways, aiming to kill or control their growth throughout the body 139.
Alkylating Agents
Alkylating agents work by adding alkyl groups to DNA, which damages the DNA and prevents cancer cells from reproducing. This class includes drugs like cyclophosphamide and cisplatin. They are effective against a wide range of cancers but can also affect normal cells, leading to side effects 139.
Antimetabolites
Antimetabolites mimic the building blocks of DNA or RNA, interfering with cell division. Examples include methotrexate and 5-fluorouracil. These drugs are particularly effective against rapidly dividing cancer cells 139.
Anti-Tumor Antibiotics
Anti-tumor antibiotics, such as doxorubicin and bleomycin, bind directly to DNA and prevent the cell from replicating. They are not the same as antibiotics used to treat infections and are used specifically for cancer treatment 139.
Topoisomerase Inhibitors
Topoisomerase inhibitors block the enzymes topoisomerase I and II, which help unwind DNA for replication. By inhibiting these enzymes, drugs like etoposide and irinotecan prevent cancer cells from dividing .
Mitotic Inhibitors and Plant Derivatives
Mitotic inhibitors, including plant alkaloids like vincristine and paclitaxel, disrupt the process of cell division by interfering with microtubules. These drugs are derived from natural sources and are used to treat various cancers 139.
Corticosteroids
Corticosteroids, such as prednisone, are sometimes used in chemotherapy regimens to reduce inflammation and suppress immune responses. They can also help manage side effects of other chemotherapy drugs .
Additional Chemotherapy Drug Classifications
Emetogenicity Classification
Chemotherapy drugs are also classified by their potential to cause nausea and vomiting (emetogenicity). Agents are grouped into five levels, from low (<10% risk) to very high (>90% risk) emetogenic potential. This classification helps guide the use of antiemetic medications to manage side effects 410.
Selective Toxicity Toward Tumor Cell Oxygenation
Some drugs are classified based on their selective toxicity toward oxygenated or hypoxic tumor cells. For example, bleomycin and vincristine are more toxic to oxygenated cells, while mitomycin C and doxorubicin are more effective against hypoxic cells. This classification is important for designing combination therapies that target different tumor environments .
Carcinogenicity and Toxicity
Chemotherapy drugs are also classified by their carcinogenic, mutagenic, and developmental toxicity risks, as determined by regulatory agencies. This information is important for healthcare providers to minimize risks to both patients and medical staff .
Combination Chemotherapy and Drug Synergy
Combination chemotherapy uses drugs from different classes to increase effectiveness and reduce resistance. Machine learning approaches are now being used to predict which drug combinations are most likely to work synergistically, especially for difficult-to-treat cancers . For example, combining kinase inhibitors with mTOR inhibitors or DNA-damaging agents has shown promise in several cancer types .
Conclusion
Chemotherapy drugs are classified in several ways, including by their mechanism of action, emetogenic potential, selective toxicity, and carcinogenic risk. The main classes—alkylating agents, antimetabolites, anti-tumor antibiotics, topoisomerase inhibitors, mitotic inhibitors, plant derivatives, and corticosteroids—form the foundation of cancer treatment. Additional classifications help guide supportive care and combination therapy strategies, improving outcomes for patients 13457910.
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