Chemotherapy of malignancy

Chemotherapy of
Malignancy
Atul
Prajapati
PHM-17-19
What is Malignancy
Malignancy=CANCER
• Cancer is a group of diseases involving
abnormal cell growth with the potential to
invade or spread to other parts of the body.
Possible signs and symptoms
• Lump
• Abnormal bleeding
• Prolonged cough
• Unexplained weight loss, and
• Change in bowel movement.
• While these symptoms may indicate
cancer, they may have other causes
Characteristic of Cancer cell
• Uncontrolled (autonomous) proliferation
• Dedifferentiation and loss of function
• Invasiveness
• Metastasis
The Cell Cycle
Malignant cells go through normal
mitosis, but synthesize DNA and divide
at a faster rate
Most chemo drugs exert antineoplastic
effects during DNA synthesis (S-phase)
or mitosis
Cell Cycle Specific (CCS) drugs
Other chemo drugs sterilize tumor cells
whether they are cycling or resting in
the Go compartment
Cell Cycle Non-Specific (CCNS)
Cell Cycle
• Go(gap 0 or resisting) non-proliferative
phase
• G1(gap i.e. presynthetic ) phase
• S (synthetic) phase
• G2(gap 2 i.e. post-synthetic) phase
• M (mitotic) phase
Classification of Antineoplastic Agents
/ Anticancer Drugs
• Alkylating Agents
– Nitrogen mustards: Melphalan, Cyclophosphamide,
Ifosfamide
– Nitrosoureas
– Alkylsulfonates
– Ethyleneimines
– Triazene
– Methyl Hydrazines
– Platinum Coordination complexes: Cisplatin, Carboplatin,
Oxaliplatin
• Antimetabolites
– Folate Antagonists: Methotrexate
– Purine antagonists
– Pyrimidine antagonists: 5-Fluorouracil, Cytarabibe
Anticancer Drugs
• Natural Products
–Plant Products
• Vinca Alkaloids: Vincristine, Vinblastine
• Taxanes: Paclitaxel, Docetaxel
• Epipodophyllotoxins: Etoposide
• Camptothecins: Irinotecan
–Microorganism Products
• Antibiotics: Doxorubicin, Bleomycin
• Enzymes: L-Asparaginase
Anticancer Drugs
• Miscellaneous
– Hydroxyurea
– Imatinib Mesylate
– Rituximab
– Epirubicin
– Bortezomib
– Zoledronic Acid
– Geftinib
– Leucovorin
– Pamidronate
– Gemcitabine
Anticancer Drugs
• Hormones and Antagonists
– Corticosteroids: Prednisone, Dexamethasone
– Estrogens: Ethinyloestradiol
– Antiestrogens: Tamoxifen
– Progesteron derivative: Megestrol Acetate
– Androgen: Testosterone propionate
– Antiandrogen: Flutamide , Bicalutamide
– Aromatase inhibitor: Letrozole , Anastrazole
– 5-alpha reductase inhibitor: Finasteride
– GnRH Analogue: Leuprolide, Buserelin
– Growth Hormone, glucagon and insulin inhibitor:
Octreotide
Types of Cancer
Types of Cancer Affected Area
Anal cancer Anus
Breast Cancer Breast
Bladder Cancer Urinary Bladder
Bone marrow Cancer Shafts of long bones
Colon Cancer Colon
Cervical Cancer Cervix
Eye Cancer Eye
Wilms tumour Kidney
Leukemia Blood
Larynx Cancer Larynx
Types of CANCER
Antineoplastic Products / Anticancer
Drugs
Sr. No. Product (INJECTION) Spec. Strengths Pack Size
1
Cyclophosphamide
Injection
BP,USP
200mg, 500mg,
1gm
1 vial
2 Methotrexate Injection BP 25mg 1 vial
3 Fluorouracil Injectrion BP 50mg 1x5 amp
4 Cisplatin Injection BP 1mg 1 vial
5
Doxorubicin Hydrochloride
Injection
BP,USP 2mg 1 vial
6
Irinotecan Hydrochloride
Injection
IP 20mg 1 vial
Anticancer (INJECTION)
Antineoplastic Products / Anticancer
Drugs
Sr. No. Product (TABLETS) Spec. Strengths Pack Size (Strip)
1
Tamoxifen Citrate
Tablets
BP,USP 10mg, 20mg 10's
2 Methotrexate Tablets BP 2.5mg,
5.0mg, 7.5mg
10's
3 Bicalutamide Tablets USP 50mg 10's
4 Anastrozole Tablets Inhouse 1mg 10's
5 Letrozole Tablets USP 2.5mg 10's
Anticancer (TABLETS)
Antineoplastic Products / Anticancer
Drugs
Sr. No. Product (CAPSULES) Spec. Strengths Pack Size
1
Hydroxyurea
Capsules
USP 500mg 10's strip
2 Imatinib Capsules Inhouse
100mg,
400mg
10's jar
3
Temozolomide
Capsules
Inhouse
20mg,
100mg,
250mg
5's jar
4 Etoposide Capsules IP,USP 50mg, 100mg 4's, 8's jar
Anticancer (CAPSULES)
Radioactive Isotopes
• Radioiodine [Sodium I-131]
Widely used to diagnose and treat thyroid
disorders, such as thyroid cancer, and I-131 has
been used as the treatment of choice for
metastatic thyroid cancer for more than 60 years
Radioactive Isotopes
• Radioactive Phosphorus [Sodium 32P]
Treatment for some blood disorders, including
one called polycythaemia vera
Polycythaemia vera means that your bone
marrow makes too many red blood cells
Response to chemotherapy may be
judged by:
• Improvement of the sense of living of
well-being of patient
• Decrease in tumour markers
• Normalization of organ function
• Shrinkage of the tumour mass
Strive to improve quality of life of Patient
• Maintenance of nutrition
• Treatment of anemia and neutropenia
• Protection from infection
• Control of symptoms
• Occupational and physiotherapy
• Adequate emotional and spiritual
support
Chemotherapy of malignancy
Chemotherapy of malignancy
1 de 24

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Chemotherapy of malignancy

  • 2. What is Malignancy Malignancy=CANCER • Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.
  • 3. Possible signs and symptoms • Lump • Abnormal bleeding • Prolonged cough • Unexplained weight loss, and • Change in bowel movement. • While these symptoms may indicate cancer, they may have other causes
  • 4. Characteristic of Cancer cell • Uncontrolled (autonomous) proliferation • Dedifferentiation and loss of function • Invasiveness • Metastasis
  • 5. The Cell Cycle Malignant cells go through normal mitosis, but synthesize DNA and divide at a faster rate Most chemo drugs exert antineoplastic effects during DNA synthesis (S-phase) or mitosis Cell Cycle Specific (CCS) drugs Other chemo drugs sterilize tumor cells whether they are cycling or resting in the Go compartment Cell Cycle Non-Specific (CCNS)
  • 6. Cell Cycle • Go(gap 0 or resisting) non-proliferative phase • G1(gap i.e. presynthetic ) phase • S (synthetic) phase • G2(gap 2 i.e. post-synthetic) phase • M (mitotic) phase
  • 7. Classification of Antineoplastic Agents / Anticancer Drugs • Alkylating Agents – Nitrogen mustards: Melphalan, Cyclophosphamide, Ifosfamide – Nitrosoureas – Alkylsulfonates – Ethyleneimines – Triazene – Methyl Hydrazines – Platinum Coordination complexes: Cisplatin, Carboplatin, Oxaliplatin • Antimetabolites – Folate Antagonists: Methotrexate – Purine antagonists – Pyrimidine antagonists: 5-Fluorouracil, Cytarabibe
  • 8. Anticancer Drugs • Natural Products –Plant Products • Vinca Alkaloids: Vincristine, Vinblastine • Taxanes: Paclitaxel, Docetaxel • Epipodophyllotoxins: Etoposide • Camptothecins: Irinotecan –Microorganism Products • Antibiotics: Doxorubicin, Bleomycin • Enzymes: L-Asparaginase
  • 9. Anticancer Drugs • Miscellaneous – Hydroxyurea – Imatinib Mesylate – Rituximab – Epirubicin – Bortezomib – Zoledronic Acid – Geftinib – Leucovorin – Pamidronate – Gemcitabine
  • 10. Anticancer Drugs • Hormones and Antagonists – Corticosteroids: Prednisone, Dexamethasone – Estrogens: Ethinyloestradiol – Antiestrogens: Tamoxifen – Progesteron derivative: Megestrol Acetate – Androgen: Testosterone propionate – Antiandrogen: Flutamide , Bicalutamide – Aromatase inhibitor: Letrozole , Anastrazole – 5-alpha reductase inhibitor: Finasteride – GnRH Analogue: Leuprolide, Buserelin – Growth Hormone, glucagon and insulin inhibitor: Octreotide
  • 11. Types of Cancer Types of Cancer Affected Area Anal cancer Anus Breast Cancer Breast Bladder Cancer Urinary Bladder Bone marrow Cancer Shafts of long bones Colon Cancer Colon Cervical Cancer Cervix Eye Cancer Eye Wilms tumour Kidney Leukemia Blood Larynx Cancer Larynx
  • 13. Antineoplastic Products / Anticancer Drugs Sr. No. Product (INJECTION) Spec. Strengths Pack Size 1 Cyclophosphamide Injection BP,USP 200mg, 500mg, 1gm 1 vial 2 Methotrexate Injection BP 25mg 1 vial 3 Fluorouracil Injectrion BP 50mg 1x5 amp 4 Cisplatin Injection BP 1mg 1 vial 5 Doxorubicin Hydrochloride Injection BP,USP 2mg 1 vial 6 Irinotecan Hydrochloride Injection IP 20mg 1 vial
  • 15. Antineoplastic Products / Anticancer Drugs Sr. No. Product (TABLETS) Spec. Strengths Pack Size (Strip) 1 Tamoxifen Citrate Tablets BP,USP 10mg, 20mg 10's 2 Methotrexate Tablets BP 2.5mg, 5.0mg, 7.5mg 10's 3 Bicalutamide Tablets USP 50mg 10's 4 Anastrozole Tablets Inhouse 1mg 10's 5 Letrozole Tablets USP 2.5mg 10's
  • 17. Antineoplastic Products / Anticancer Drugs Sr. No. Product (CAPSULES) Spec. Strengths Pack Size 1 Hydroxyurea Capsules USP 500mg 10's strip 2 Imatinib Capsules Inhouse 100mg, 400mg 10's jar 3 Temozolomide Capsules Inhouse 20mg, 100mg, 250mg 5's jar 4 Etoposide Capsules IP,USP 50mg, 100mg 4's, 8's jar
  • 19. Radioactive Isotopes • Radioiodine [Sodium I-131] Widely used to diagnose and treat thyroid disorders, such as thyroid cancer, and I-131 has been used as the treatment of choice for metastatic thyroid cancer for more than 60 years
  • 20. Radioactive Isotopes • Radioactive Phosphorus [Sodium 32P] Treatment for some blood disorders, including one called polycythaemia vera Polycythaemia vera means that your bone marrow makes too many red blood cells
  • 21. Response to chemotherapy may be judged by: • Improvement of the sense of living of well-being of patient • Decrease in tumour markers • Normalization of organ function • Shrinkage of the tumour mass
  • 22. Strive to improve quality of life of Patient • Maintenance of nutrition • Treatment of anemia and neutropenia • Protection from infection • Control of symptoms • Occupational and physiotherapy • Adequate emotional and spiritual support