Search Site | Index

About Lymphoma | Advocacy | Art | CAM | Clinical trials 
Doctors - Experts - Centers | Guidelines at Diagnosis | News
Risk Factors | Side Effects | Statistics | Support | Symptoms |
Tests | Treatments | Types of Lymphoma | How to Help


Find Clinical Trial

 by Agent

by Type of Lymphoma & Treatment Status  

Trials of Interest

New trials since October 2018

 
Phase I since 2017  | Phase III since 2008
 

Guidelines at Diagnosis | About Clinical Trials

evidence-based support and information

 

Treatments > Chemo agents & mechanisms

Last update: 03/03/2014

TYPES
DNA-Altering | Anti-tumor Antibiotics | Antimetabolites | DNA Repair Enzyme Inhibitors | Block Cell Duplication
Proteasome inhibition | Rituxan | Steroidal

Recommended Reading: 

General Mechanisms of Drug Action ncbi.nlm.nih.gov 
Cancer Multidrug Resistance (MDR)  nature.com
How Chemotherapy Works Cancer.org
Chemotherapy Overview oralcancerfoundation.org 

"The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis)." chemocare.com

 

DNA-Altering Drugs
Alkylating agents:

DNA cross linking is a primary role of agents

Replicating cells are most susceptible to agents

Alkylating agents are not cell cycle specific 

fpnotebook.com

Also see Consequences and Targets of Alkylating Agents
  PDF  

 

Return to top

DNA-Altering Drugs

These drugs change DNA, the building block of cells, to prevent cell growth.
bullet
Bendamustine - micromedex.com  > Treatment abstracts
bullet
Carboplatin (Paraplatin®) -  BCCancer | Cancerbacup
bullet
Carmustine (BCNU®) - BCCancer | Cancerbacup |  MedlinePlus  
bullet
Chlorambucil (Leukeran®) -  BCCancer | Cancerbacup > Treatment abstracts
bullet
Cisplatin (Platinol®) - BCCancer | Cancerbacup | MedlinePlus
bullet
Evaluation of long-term toxicity in patients after cisplatin-based chemotherapy for non-seminomatous testicular cancer - PubMed
bullet
Cyclophosphamide injection (Cytoxan®) -  BCCancer | Cancerbacup
bullet
Cyclophosphamide oral  (Cytoxan®) -  BCCancer
bullet
Dacarbazine (DTIC®) - BCCancer |  Cancerbacup | MedlinePlus
bullet
Ifosfamide (ifex®)Lomustine (CCNU®) -  BCCancer | Cancerbacup | MedlinePlus
bullet
Mechlorethamine (nitrogen mustard, Mustargen®) - BCCancer |  MedlinePlus
bullet
Melphalan (Alkeran®) - BCCancer |  Cancerbacup | MedlinePlus
bullet
Procarbazine (Matulane®) -   BCCancer | Cancerbacup | MedlinePlus
Anti-tumor Antibiotics

Interact with DNA and decrease cell survival

 

Return to top

Anti-tumor Antibiotics

These drugs interact with DNA and decrease cell survival. Drugs that come from natural sources, such as plants or yeast, include the following. Click link to read details.
bullet
Bleomycin (Blenoxane®) -  BBCancer |  Cancerbacup | MedlinePlus
bullet
Doxorubicin (Adriamycin®, Rubex®) anthracyline drug-  BCCancer | Cancerbacup | MedlinePlus
bullet
Doxorubicin, Liposomal (Doxil) - BBCancer | MedlinePlus | Project Inform  
Full prescribing info from Doxil.com - PDF | PDF-Help  | Cancerbacup
bullet
Epirubicin,  anthracyline drug http://www.cancerbacup  | nlm.nih.gov 
bullet
Idarubicin (Idamycin®) -  BBCancer | Cancerbacup | MedlinePlus
bullet
Mitoxantrone (Novantrone®) -  BBCancer | Cancerbacup | MedlinePlus
Antimetabolites -
About Antimetabolites - pharmacology.unmc.edu

"Antimetabolites are very similar to normal substances within the cell.  When the cells incorporate these substances into the cellular metabolism, they are unable to divide.  Antimetabolites are cell-cycle specific.  They attack cells at very specific phases in the cycle.  Antimetabolites are classified according to the substances with which they interfere." chemocare.com

Return to top

 

 

Antimetabolites

These drugs interfere with normal cell growth.
bullet
Chlorodeoxyadenosine (Cladribine®) - BBCancer | MedlinePlus  
Other names:  2-chlorodeoxyadenosine; 2-CdA
bullet
Cytarabine IV  (cvtosine arabinoside, Ara-C, Cytosar  - BBCancer |  MedlinePlus
bullet
Fludarabine IV (Fludara®)  -  BCCancer | Cancerbacup | MedlinePlus
bullet
Fludarabine oral  (Fludara®)  -  BCCancer | Cancerbacup | MedlinePlus
bullet
Gemcitabine (Gemzar®) - BBCancer | Treatment abstracts
bullet
Mercaptopurine oral (Purinethol®) - BBCancer | MedlinePlus | Cancerbacup
bullet
Methotrexate oral (Rheumatrex®) - BBCancer| MedlinePlus  | Cancerbacup
Other name: amethopterin
bullet
Pentostatin  IV (Nipent®) - BBCancer |  MedlinePlus
bullet
Thioguanine oral (Lanvis®)  - BBCancer | MedlinePlus | Cancerbacup
DNA Repair Enzyme Inhibitors

 

Return to top

DNA Repair Enzyme Inhibitors

These drugs act on certain proteins (enzymes) that normally work to repair faulty DNA and therefore make cells more likely to die when they are injured.
  • Etoposide oral (VP-16, VePesid®, Etopophos) - BBCancer
  • Etoposide IV (VP-16, VePesid®, Etopophos) - BBCancer |  MedlinePlus  
Block Cell Duplication --
Damage cell structures that are required for a cell to divide
Microtubule inhibitors
About mechanism of action

 

Return to top

Block Cell Duplication

These drugs damage cell structures required for cells to divide.
bullet
Vinblastine (Velban®) - BBCancer | Cancerbacup | MedlinePlus
bullet
Vincristine (Oncovin®) -  BBCancer | Cancerbacup | MedlinePlus
Vinorelbine is a  vinca alkaloid that interferes with microtubule assembly.
  •  Vinorelbine (Navelbine®)  - FDA | BBCancer | Treatment abstracts

 

Targets Proteasome

inhibits  proteasomal degradation 

"The proteasomal degradation pathway is essential for many cellular processes, including the cell cycle, the regulation of gene expression, and responses to oxidative stress."

wikipedia

Velcade is classified as a targeted therapy because it inhibits proteasomal
degradation within the cell. I'll try to explain what that means: 

A cancer cell is like an unruly engine that races fast, burns lots of gas, and runs unevenly ... and so it expels more byproducts than an engine that runs 
normally. The way velcade works is to close down the waste disposal (exhaust) system of the cell (the proteasome) so that the engine is less able expel the large amount of cellular waste (proteins), causing the 
abnormally running cells to choke and stall out. Normal cells are less effected by the inhibition of the cellular garbage disposal system because they run more efficiently.

 

Return to top

 

Targets Proteasome

bullet
Velcade (bortezomib)  Approved for Mantle Cell lymphoma (MCL)
bullet
FDA full prescribing information PDF  
bullet
Highlights of prescribing information
bullet
Mantle Cell: Multicenter phase II study of bortezomib in patients with relapsed or refractory mantle cell lymphoma. J Clin Oncol. 2006 Oct 20;24(30):4867-74. Epub 2006 Sep 25.  PMID: 17001068

RESULTS: In total, 155 patients were treated. Median number of prior therapies was one (range, one to three). 

Response rate in 141 assessable patients was 33% including 8% complete response (CR)/unconfirmed CR. Median DOR was 9.2 months. Median TTP was 6.2 months. 

Results by investigator assessments were similar. Median OS has not been reached after a median follow-up of 13.4 months. The safety profile of bortezomib was similar to previous experience in relapsed multiple myeloma. 

The most common adverse events grade 3 or higher were peripheral neuropathy (13%), fatigue (12%), and thrombocytopenia (11%). Death from causes that were considered to be treatment related was reported for 3% of patients. 

CONCLUSION: These results confirm the activity of bortezomib in relapsed or refractory MCL, with predictable and manageable toxicities. Bortezomib provides significant clinical activity in terms of durable and complete responses, and may therefore represent a new treatment option for this population with usually very poor outcome. Studies of bortezomib-based combinations in MCL are ongoing.
bullet
Other lymphomas: Phase II clinical experience with the novel proteasome inhibitor bortezomib in patients with indolent non-Hodgkin's lymphoma and mantle cell lymphoma. Abstract 
Steroidal 
(Corticosteroids)
steroidal: anti-inflammatory, Immunosuppressant
 
Return to top

Steroidal (Corticosteroids)

Corticosteroids, including Prednisone, Prednisolone, Methylprednisolone and Dexamethasoneare are a group of synthetic hormones closely related to cortisol (a glucocorticoid), a natural hormone produced in the adrenal cortex.
"Prednisone decreases inflammation by preventing white blood cells from functioning properly.  More specifically, the drug interferes with lymphocytes (one of several types of white blood cells).  The presence of  white blood cells result in inflammation (for many reasons, damage to tissue, fungus, virus, bacteria, allergens and almost any foreign invader) - they go to a site and their presence inflames the area.  Prednisone causes lymphocytes to break apart and die."  Source: members.cox.net 
bullet
Recent insights into the mechanism of glucocorticosteroid-induced apoptosis.

Cell Death Differ. 2002 Jan;9(1):6-19. Review. PMID: 11803370  

Glucocorticosteroid hormones induce apoptosis (cell death) in lymphocytes.
bullet
Corticosteroids in the Treatment of Neoplasms ncbi.nlm.nih.gov 
bullet
Dexamethasone (Decadron®)  BBCancer | MedlinePlus
bullet
Methylprednisolone (Medrol®) MedlinePlus
bullet
Prednisone (Deltasone®)  BBCancer | MedlinePlus
Also see: Side Effects > Prednisone (Corticosteroids)

Background:

bullet
Glucocorticoids Disease Mechanism II: Inflammation - Powerful Anti-inflammatory Compounds stanford.edu
bullet
Pretreatment with glucocorticoids enhances T-cell effector function: possible implication for immune rebound accompanying glucocorticoid withdrawal.
Cell Transplant. 1999 Nov-Dec;8(6):637-47. PMID: 10701493 | Related abstracts
bullet
Mechanisms of anti-inflammatory action  Related abstracts
bullet
Mechanisms of killing lymphoid cells Related abstracts
bullet
Overview & side effects About.com
 
Disclaimer:  The information on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns, you should always consult your doctor. 
Copyright © 2004,  All Rights Reserved.