From the Guidelines
Chemotherapy agents can be broadly classified into categories such as alkylating agents, antimetabolites, microtubule inhibitors, and platinum agents, among others, with the most recent and highest quality study suggesting that taxanes, anthracyclines, antimetabolites, and platinum agents are preferred for the treatment of stage IV or recurrent metastatic breast cancer 1. The classification of chemotherapy agents is crucial in determining the most effective treatment regimen for patients with cancer.
- Alkylating agents, such as cyclophosphamide and carboplatin, work by directly damaging DNA, preventing cancer cell replication.
- Antimetabolites, including capecitabine and gemcitabine, interfere with DNA and RNA production by mimicking natural metabolites.
- Microtubule inhibitors, such as eribulin and vinorelbine, disrupt microtubule formation, preventing cell division.
- Platinum agents, including cisplatin and carboplatin, cross-link DNA strands, preventing cancer cell replication. According to the NCCN panel, the treatment decision should be individualized and consider previous therapies, pre-existing comorbidities, nature of the disease, toxicity profiles, patient preferences, and in some cases access to agents 1. The NCCN panel has included taxanes, such as paclitaxel, anthracyclines, such as doxorubicin and liposomal doxorubicin, antimetabolites, such as capecitabine and gemcitabine, and platinum agents for patients with triple-negative tumors and germline BRCA1/2 mutations as preferred single agents 1. The choice of chemotherapy agent should be based on the individual patient's needs and the specific type of cancer being treated, with a focus on minimizing toxicity and maximizing efficacy, as evidenced by the improved overall survival (OS) with weekly administration of paclitaxel compared to every-3-week treatment 1.
From the FDA Drug Label
Doxorubicin, as a component of intensive chemotherapy regimens administered to pediatric patients, may contribute to prepubertal growth failure. It may also contribute to gonadal impairment, which is usually temporary. Pediatric patients treated with doxorubicin or other topoisomerase II inhibitors are at a risk for developing acute myelogenous leukemia and other neoplasms
- The classification of doxorubicin is as an anthracycline and a topoisomerase II inhibitor 2, 2.
- Key points about doxorubicin classification:
- Topoisomerase II inhibitor: doxorubicin works by inhibiting the enzyme topoisomerase II, which is involved in DNA replication.
- Anthracycline: doxorubicin is a type of anthracycline antibiotic, which is a class of chemotherapeutic agents.
From the Research
Classification of Chemotherapy
The classification of chemotherapy can be divided into several categories, including:
- Alkylating agents: These agents work by adding an alkyl group to the DNA of cancer cells, which interferes with their ability to reproduce 3.
- Antimetabolites: These agents interfere with the normal metabolic processes of cancer cells, preventing them from growing and dividing 3, 4, 5, 6.
- Anthracycline antibiotics: These agents work by intercalating into DNA and disrupting the topoisomerase enzymes, which are necessary for DNA replication 3, 7.
- Plant alkaloids: These agents work by inhibiting microtubule formation, which is necessary for cell division 3.
- Topoisomerase inhibitors: These agents work by inhibiting the topoisomerase enzymes, which are necessary for DNA replication 4.
Examples of Chemotherapy Agents
Some examples of chemotherapy agents include:
- Cyclophosphamide: an alkylating agent 5, 6, 7.
- Methotrexate: an antimetabolite 5, 6.
- 5-Fluorouracil: an antimetabolite 4, 5, 6.
- Cisplatin: a platinum-based agent that works by cross-linking DNA 4, 7.
- Etoposide: a topoisomerase inhibitor 4, 7.
Combination Chemotherapy
Combination chemotherapy, which involves the use of multiple chemotherapy agents, is commonly prescribed than monotherapy 3. The goals of combination chemotherapy can be curative or palliative, and it can be used to increase the efficacy of other treatments such as radiotherapy 3.