Cancer Medicines

Erlotinib	Erlotinib (sold under the trade name Tarceva) is a drug used in the treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) and in the treatment of patients with locally advanced, unresectable or metastatic pancreatic cancer. Erlotinib is a type of cancer treatment drug called a tyrosine kinase inhibitor (TKI). It works by blocking particular proteins on cancer cells that encourage the cancer to grow. Erlotinib blocks proteins called epidermal growth factor receptors (EGFR). Cancers that have these receptors are called EGFR positive. For lung cancer, doctors check your cancer cells to see if they have the receptors before you have this treatment. Erlotinib may shrink the cancer or stop it growing for a time. Erlotinib is given in tablet form to be taken by mouth at least one hour before or two hours after eating. The tablets are supplied in 25mg, 100mg and 150mg strengths.
Gefitinib	Gefitinib (sold under the trade name Iressa) , like Erlotinib, is a targeted therapy that selectively targets the mutant proteins in malignant cells. It is used for the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) and certain other cancers. Gefitinib is a type of cancer treatment drug called a tyrosine kinase inhibitor (TKI). It works by blocking particular proteins on cancer cells that encourage the cancer to grow. Gefitinib blocks proteins called epidermal growth factor receptors (EGFR). Cancers that have these receptors are called EGFR positive. Tests are done on the cancer cells from a lung biopsy or previous surgery to check the level of EGFR. This tells your doctor whether Gefitinib is likely to be of benefit to you. Gefitinib is a pill, taken by mouth, once daily. It can be taken with or without food.
Crizotinib	Crizotinib (sold under the trade name Xalkori and Crizalk) is used in the treatment of certain types of lung cancers. Crizotinib is a type of tyrosine kinase inhibitor. Kinases are enzymes that are involved in many functions, including cell growth and reproduction. Crizotinib blocks the anaplastic lymphoma kinase (ALK) and also the c-MET/hepatocyte growth factor receptor. This action disrupts certain pathways in the cell, which can prevent the growth of tumor cells. Crizotinib is made especially for the treatment of a type of lung cancer in which ALK is overactive due to an abnormality in the ALK gene. About 5 in 100 people (5%) with NSCLC have this. It is called ALK positive disease. This medication is given as a hard gelatin capsule taken by mouth. Usually, crizotinib is taken twice daily. Capsules can be taken with or without food, and should be swallowed whole (not crushed, chewed, or split). The duration of treatment depends on several factors, including how well the cancer is responding to the drug.
Imatinib	The revolutionary cancer drug Imatinib (Gleevec) is part of a new group of targeted treatments designed to attack a specific cancer-causing molecule. Imatinib is primarily used for the treatment of chronic myelogenous leukemia (CML) and acute lymphocytic leukemia (ALL) that is Philadelphia chromosome-positive (Ph+) and certain types of gastrointestinal stromal tumors (GIST), systemic mastocytosis, and myelodysplastic syndrome. Imatinib is a type of biological therapy called a tyrosine kinase inhibitor (TKI). Tyrosine kinases are proteins that cells use to signal to each other to grow. They act as chemical messengers. There are a number of different tyrosine kinases and blocking them stops the cancer cells from growing. Imatinib is the first member of a new class of agents that act by inhibiting particular tyrosine kinase enzymes, instead of non-specificaly inhibiting rapidly dividing cells. You have imatinib as a tablet that you swallow whole, with a glass of water after food. You must take tablets according to the instructions your doctor or pharmacist gives you.
Sorafenib	Sorafenib (sold under the brand name Nexavar) is a type of biological therapy called a protein tyrosine kinase inhibitor (TKI). Tyrosine kinase is a protein which acts as a chemical messenger (an enzyme). There are a number of different tyrosine kinases that encourage cancer cells to grow. Sorafenib blocks some of the protein kinases and is called a multi kinase inhibitor. It works in two ways. It stops signals that tell cancer cells to grow. It also stops cancer cells forming new blood vessels, which they need to grow. Treatment that stops blood vessels forming is called anti-angiogenesis treatment. Sorafenib is licensed to treat people with- 1.) Kidney cancer that has spread outside the kidney (advanced or metastatic renal cell cancer) and who are no longer being helped by treatment with interferon alpha (IFN) or interleukin-2 (IL-2), or for whom these drugs are not suitable. 2.) Liver cancer (hepatocellular carcinoma) that can’t be removed with surgery. 3.) Differentiated thyroid cancer (DTC) that is no longer being controlled by radioactive iodine treatment. The recommended daily dose of Sorafenib is 400 mg (2 x 200 mg tablets) taken twice daily without food (at least 1 hour before or 2 hours after a meal). Treatment should continue until the patient is no longer clinically benefiting from therapy or until unacceptable toxicity occurs.
Chlorambucil Tablet	Chlorambucil (sold under the brand name Leukeran) is an Oral chemotherapy drug used to treat certain types of cancers of the blood and lymph nodes like chronic lymphocytic leukaemia (CLL), low-grade non-Hodgkin lymphoma, Hodgkin lymphoma and Waldenstrom's macroglobulinaemia. In some cases, it may be prescribed as a treatment for certain blood disorders or kidney problems. Chlorambucil belongs to a group of drugs called alkylating agents. It works by sticking to one of the other cancer cell's DNA strands, due to which the cancer cell cannot divide.
Temozolomide	Temozolomide is a cytotoxic alkylating agent with antineoplastic activity. It is a “pro-drug,” which means it is converted into its cancer-fighting form once inside the body. It binds to the DNA in cells and interferes specifically with cell growth and division. Temozolomide (TMZ; brand names Temodar and Temodal and Temcad) is an oral chemotherapy drug used as a treatment of some brain cancers; as a second-line treatment for astrocytoma and a first-line treatment for glioblastoma multiforme Temozolomide (TMZ) is the first new chemotherapy agent to be approved for the treatment of high-grade malignant gliomas in more than 20 years. This novel oral alkylating agent has demonstrated promising activity not only in brain tumors, but in a variety of solid tumors, including malignant melanoma. TMZ is 100% bioavailable when taken orally and, because of its small size and lipophilic properties, it is able to cross the blood-brain barrier. Concentrations in the central nervous system are approximately 30% of plasma concentrations. Once it has entered the central nervous system, TMZ can be spontaneously converted to the active metabolite. These pharmacologic properties make it an ideal agent for treating central nervous system malignancies. In patients with advanced metastatic melanoma, brain metastases are a major cause of treatment failure. In this setting, TMZ has been shown to be as effective as dacarbazine, with a similar safety profile. More importantly, there is evidence to suggest that TMZ-treated patients have a lower incidence of central nervous system relapse compared with dacarbazine-treated patients. Therefore, TMZ is actively being investigated for the treatment and prevention of brain metastases in melanoma patients. TMZ may become an important part of treatment regimens for advanced metastatic melanoma. Temozolomide comes in strenghths of 5 mg, 20 mg, 100 mg and 250 mg. It is taken on an empty stomach (1 hour before or 2 hours after meals or at bedtime).
Docetaxel	Docetaxel (sold under the brand name Taxotere) is a clinically well established anti-mitotic chemotherapy medication used mainly for the treatment of breast, ovarian, and non-small cell lung cancer. Docetaxel works by attacking cancer cells. Every cell in the body contains a supporting structure (almost like a skeleton) called the microtubular network. If this "skeleton" is changed or damaged, the cell can't grow or reproduce. Docetaxel makes the "skeleton" in cancer cells unnaturally stiff, so that these cells can no longer grow. Docetaxel is given through a vein (intravenously, IV). There is no pill form of docetaxel. Pre-medication with a corticosteroid pill starting a day prior to docetaxel infusion for 3 days is given to reduce the severity of fluid retention and allergic reactions.
Bortezomib Injection	Bortezomib (available under brand names Velcade, Neomib and Bortecad) belongs to the group of cancer-fighting medications known as antineoplastics. It works by killing cancer cells. Bortezomib is used to treat certain types of cancers like Multiple Myeloma (cancer of the bone marrow), Mantle Cell Lymphoma (a type of non-Hodgkins lymphoma),etc. The recommended dose of Bortezomib varies according to body size. It is injected into a vein (intravenously) or under the skin (subcutaneously), once or twice weekly, for varying periods of time, depending on the condition being treated. There should be a minimum of 72 hours between each dose of bortezomib.
Bevacizumab Injection	Bevacizumab (available under brand name Avastin) is a man-made antibody (IgG1). It is given intravenously to treat cervical cancer, colorectal cancer, glioblastoma multiforme, non-small cell lung cancer (NSCLC), ovarian cancer, and renal cell cancer. It is also used to treat specific eye disease. This drug works by blocking a certain protein (vascular endothelial growth factor-VEGF) thereby decreasing the blood supply to the tumor and slowing tumor growth. For age-related macular degeneration it is given by injection into the eye.
Capecitabine	Capecitabine (available under brand name Xeloda) is an orally-administered chemotherapeutic agent used in the treatment of metastatic breast cancer, gastric cancer and colorectal cancer. For breast cancer it is often used together with docetaxel. Capecitabine is a prodrug, that is enzymatically converted to fluorouracil (antimetabolite) in the tumor, where it inhibits DNA synthesis and slows growth of tumor tissue.
Carboplatin	Carboplatin (sold under the trade name Paraplatin) is an anticancer ("antineoplastic" or "cytotoxic") chemotherapy drug most commonly used to treat ovarian and lung cancer. It may also be used to treat other types of cancers like head and neck cancer, brain cancer, uterine cancer, cancer of the cervix, breast cancer, bladder cancer and testicular cancer. Carboplatin is a heavy metal compound that belongs to a class of drugs known as platinum-containing compounds, which belong in the larger group of alkylating agents. Carboplatin inhibits synthesis of RNA, DNA, and protein in cells. All of these compounds are vital for cells to divide and grow. By preventing them from dividing, the medication can stop the cancer from growing and spreading in the body. Carboplatin is usually given by infusion into a vein (intravenous, IV). Carboplatin can also be given intra-peritoneal, directly into the peritoneal cavity in the abdomen. Carboplatin is usually given once every three weeks. This pattern is known as a ‘cycle’ or ‘course.’ When carboplatin is given on its own, it takes between 30 and 90 minutes, but the total time may be longer when it’s given with other drugs. The Dosage, Frequency of cycles and the total number of cycles is decided by the doctor after taking into consideration the condition and overall health of the patient.
Gemcitabine	Gemcitabine (sold under the trade name Gemzar) is an anti-cancer ('antineoplastic' or 'cytotoxic') chemotherapy drug. Gemcitabine is classified as an antimetabolite. Antimetabolites are drugs that interfere with DNA production. This stops cell growth and division, resulting in the slowing or stopping of cancer growth. Since cancer cells, in general, divide faster and with less error-correcting than healthy cells, cancer cells are more sensitive to this damage. Gemcitabine kills cancer cells undergoing DNA synthesis. It inhibits ribonucleotide reductase, an enzyme important to DNA synthesis. Because cells cannot copy their DNA, they cannot properly divide, and thus die. Gemcitabine is used to treat different cancers including cancers of the pancreas, bladder, ovary and breast, and non-small cell lung cancer (NSCLC). Gemcitabine is given as a drip (infusion) into a vein, which usually takes 30 minutes. You may have it through a fine plastic tube (a cannula), which is put into a vein in your arm or hand each time you have treatment. Or you may it through a central line, such as a PICC line, Hickmann line or a portacath.These are tubes that deliver drugs directly into a large vein in your chest, and stay in place for as long as your course of chemotherapy lasts. Gemcitabine is usually given in a four-week cycle, over several months. You will have a dose of the drug once a week for three weeks, with a break from treatment on the fourth week, before starting your next cycle. The exact number of cycles you have will depend on how well the treatment works. If you are having gemcitabine after surgery, you will have six cycles, as long as you are able to cope with it. Your nurse or doctor will tell you more about this.
Irinotecan	Irinotecan (Camptosar) is a semisynthetic, water-soluble derivative of camptothecin, which is a cytotoxic alkaloid extracted from plants such as Camptotheca acuminata. Irinotecan and its active metabolite, SN-38, inhibit the action of 'topoisomerase I'. 'Topoisomerase I' is an enzyme that produces reversible single-strand breaks in DNA during DNA replication. These single-strand breaks relieve torsional strain and allow DNA replication to proceed. Irinotecan and SN-38 bind to the topoisomerase I-DNA complex and prevent religation of the DNA strand, resulting in double-strand DNA breakage and cell death. Irinotecan is approved to be used alone or with other drugs to treat colorectal cancer that has metastasized (spread to other parts of the body), including metastatic cancer that has recurred (come back) or has not gotten better with other chemotherapy. It is also being studied in the treatment of other types of cancers like pancreatic cancer and small cell lung cancer. It is usually given with other cancer medicines in a combination chemotherapy. For small cell lung cancer it is used with cisplatin. For colon cancer it is used either alone or with fluorouracil. It is given intravenously.
Oxaliplatin	Oxaliplatin (sold under the brand name Eloxatin) belongs to a new class of platinum agents. It contains a platinum atom complexed with oxalate and diaminocyclohexane (DACH). The bulky DACH is thought to contribute greater cytotoxicity than cisplatin and carboplatin. It is typically administered in combination with fluorouracil and leucovorin in a combination known as Folfox for the treatment of colorectal cancer. This medication is given as an injection into a vein. Usually, oxaliplatin is given once every 2 weeks. The exact dose and schedule of treatment depends on several factors, including how well the cancer is responding to the drug.
Paclitaxel	Paclitaxel (sold under the brand name Taxol) is used in the treatment of breast, ovarian, and lung cancer, and Kaposi’s sarcoma. It may also be used to treat esophageal, head and neck, bladder, uterine and cervical cancers. Paclitaxel belongs to a class of drugs known as plant alkaloids. These drugs are also known as antimicrotubule agents. Microtubules are involved in cell replication. By inhibiting their function, paclitaxel helps stop or slow the growth of cancer. This medication is given as an injection into a vein (intravenous). Usually, paclitaxel is given once every 3 weeks. The length of time needed for the injection and the duration of treatment varies depending on several factors, such as the type of cancer being treated, what other medications are involved, how well the drug is working, and how well your body is able to tolerate treatment. Your doctor will recommend a therapy that is tailored to your needs.
Rituximab	Rituximab injection (Rituxan) and rituximab and hyaluronidase human injection (Rituxin Hycela) are used alone or with other medications to treat certain types of non-Hodgkin's lymphoma (NHL; a type of cancer that begins in a type of white blood cells that normally fights infection) and chronic lymphocytic leukemia (CLL; a type of cancer that begins in the white blood cells). Rituximab injection is also used with another medication to treat the symptoms of rheumatoid arthritis (RA; a condition in which the body attacks its own joints, causing pain, swelling, and loss of function). In the treatment of rheumatoid arthritis, rituximab is used when other biologic medications called the tumor necrosis factor (TNF) inhibitor (e.g. infliximab, etanercept, or adalimumab) have failed to be effective. The effectiveness of rituximab is a result of it temporarily depleting the number of B-cells, cells of the immune system that are important in promoting inflammation in rheumatoid arthritis. Rituximab injection is also used with other medications to treat granulomatosis with polyangiitis (Wegener's Granulomatosis) and microscopic polyangiitis which are conditions in which the body attacks its own veins and other blood vessels, which causes damage to organs, such as the heart and lungs. Rituximab is in a class of medications called monoclonal antibodies. Other monoclonal antibodies include trastuzumab (Herceptin) and gemtuzumab ozogamicin (Mylotarg). These drugs are sometimes called targeted (biological) therapies. They work by ‘targeting’ specific proteins (receptors) on the surface of cells. Rituximab targets a protein called CD20, which is found on the surface of white blood cells called B-lymphocytes (B-cells). CD20 is found on normal B-cells. It is also found on most of the abnormal (malignant) B-cells that occur in many types of NHL, and some of the abnormal B-cells that occur in CLL. Rituximab locks on to CD20, and then triggers the body’s immune system to attack the cells and destroy them. Rituximab destroys both abnormal and normal B-cells. Once treatment is over the body can replace the normal B-cells.
Ruxolitinib	Ruxolitinib (sold under the trade names Jakafi / Jakavi) is a targeted therapy. Ruxolitinib is a type of drug called a protein kinase inhibitor. It is an oral drug indicated for the treatment of patients with intermediate or high-risk myelofibrosis, including primary myelofibrosis, post-polycythemia vera myelofibrosis and post-essential thrombocythemia myelofibrosis. Genes called JAK1 and JAK2 help control the number of blood cells the body makes. If either of these genes become faulty, the body may make too many blood cells. Ruxolitinib blocks (inhibits) the signals that are sent by the faulty gene. This helps reduce the number of extra blood cells that are made.
Topotecan	Topotecan (trade name Hycamtin) is a semisynthetic, water-soluble derivative of camptothecin, which is a cytotoxic alkaloid extracted from plants such as Camptotheca acuminata. Topotecan is an intravenous topoisomerase I inhibitor used in the treatment of cervical and small cell lung cancers (SCLC). Topotecan is a drug originating from a family of chemotherapeutic agents that inhibit the DNA topoisomerase I enzyme. The DNA topoisomerase I enzyme is responsible for relaxing a supercoiled DNA helix during DNA synthesis. Topotecan inhibits the religation step of the enzymatic reaction by stabilizing the DNA enzyme complex. It then causes accumulation of persistent single strand DNA breaks which eventually causes cell death.
Trabectedin	Trabectedin (Yondelis) is an antitumoral agent. It has a unique mechanism of action. It binds to the minor groove of DNA interfering with cell division and genetic transcription processes and DNA repair machinery, which results in the death of the cell. Since cancer cells, in general, divide faster, and with less error-correcting than healthy cells, they are more sensitive to this damage. Indicated for unresectable or metastatic liposarcoma or leiomyosarcoma in patients who have received a prior anthracycline-containing regime. Trabectedin is administered intravenously (IV, into a vein).
Trastuzumab	Trastuzumab (Herceptin) is one of a group of cancer drugs called monoclonal antibodies. Monoclonal antibodies are sometimes called targeted therapies because they work by ‘targeting’ specific proteins (receptors) on the surface of cells. It is approved for the treatment of early-stage breast cancer that is Human Epidermal growth factor Receptor 2-positive (HER2+) and has spread into the lymph nodes. Some cancers have too much of a protein called human epidermal growth factor receptor 2 (HER2) on the surface of their cells. These are called HER2-positive cancers. The extra HER2 receptors stimulate the cancer cells to divide and grow. Trastuzumab locks on to the HER2 protein and blocks the receptor. This stops the cells from dividing and growing. Trastuzumab only works when the cancer cells have high levels of a protein called human epidermal growth factor receptor 2 (HER2). Trastuzumab is administered intravenously (IV, into a vein).
Triptorelin	Triptorelin sold under the brand names Decapeptyl and Gonapeptyl among others is a hormonal therapy drug used to treat prostate cancer. It is a medication that causes stimulation of the pituitary, thus decreasing secretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH). Triptorelin is a gonadotropin releasing hormone (GnRH) agonist that is a potent inhibitor of the synthesis of testosterone (in men) and estrogen (in women) and is used to treat advanced prostate cancer. Triptorelin, is administered as an injection into the muscle (intramuscularly) or just under the skin (subcutaneously).

Oncology Medicines. Cancer Medicines