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Drugs used to treat cancer

The first major successes in the field of modern chemotherapy of oncological diseases were achieved in the 1940s, when, during the Second World War, they began to study in detail the effects on the body of chemical warfare agents: mustard gas, or bis (Ab-chloroethyl) sulfide, and nitrogenous mustard, or trichloroethylamine. Even earlier (in 1919) it became known that nitrogen mustard causes leukopenia and aplasia of the bone marrow. Further studies have shown that nitrogen mustard has a specific cytotoxic effect on lymphoid tissue and has antitumor activity in lymphosarcoma in mice. In 1942, clinical trials of trichloroethylamine were started, which marked the beginning of the era of modern chemotherapy of tumors.
Soon, a series of bis- (Ab-chloroethyl) -amine or bis- (2-chloroethyl) -amine derivatives was synthesized, and some of them have been used as antitumor agents.
According to the mechanism of action, drugs of this group are considered as K alkylating substances, since they form covalent bonds (exhibiting an alkylating property) with nucleophilic compounds, including those with biologically important radicals like phosphates, amines, sulfhydryl, imidazole groups, etc.
The cytotoxic and other effects of alkylating compounds are primarily due to the alkylation of the structural elements of DNA (purines, pyrimidines).
Following bis-A (b-chloroethyl) amines, cytostatic alkylating compounds of other chemical groups were obtained: ethylene imine, alkylated sulfonate, triazene.
In the early 60s, anticancer agents of another mechanism of action, Cantimetabolites, were detected. Methotrexate, which has structural similarity with folic acid and is its antimetabolite, has been effective in some human tumors, especially in women with choriocarcinoma and in acute leukemia.
Following this, the antitumor properties of other antimetabolites were found: purine analogues, (mercaptopurine, thioguanine) and pyrimidine (fluorouracil and its analogs, cytarabine, etc.).
Later, a number of antibiotics (adriamycin, olivomycin, dactinomycin, etc.), enzymes (L-asparaginase), some alkaloids (vinblastine - rozevin, vincristine), platinum preparations and a number of other compounds were used as antitumor drugs.
For the treatment of hormone-dependent tumors, a number of estrogenic, androgenic and progestin drugs (progestins), as well as estrogen antagonists (antiestrogens - tamoxifen, etc.) and androgen antagonists (antiandrogens - flutamide, etc.) have received widespread use.
In recent years, endogenous antitumor compounds have attracted much attention. Efficacy has been found in some types of Interferon tumors (see), the antitumor activity of other lymphokines is studied (interleukins 1 and 2).
Along with a specific inhibitory effect on tumors, modern antitumor agents act on other tissues and systems of the body, which, on the one hand, causes their side effects, and on the other, allows them to be used in other areas of medicine.
One of the main side effects of most anticancer drugs is their inhibitory effect on the blood-forming organs, which requires special attention and precise dose control and regimen of drug use. It must be borne in mind that the suppression of hemopoiesis increases with combination therapy - combined use of drugs, radiation therapy, etc. Loss of appetite, diarrhea, alopecia and other side effects are often observed. Some antitumor antibiotics have cardiotoxicity (adriamycin, doxorubicin, etc.), and nephrototoxicity.
With the use of certain drugs may develop hyperuricemia (see Allopurinol).
Estrogens, androgens, their analogues and antagonists can cause hormonal disorders (often gynecomastia).
One of the characteristic features of a number of anticancer drugs is their immunosuppressive effect, which can weaken the body's defenses and facilitate the development of infectious complications. At the same time, in connection with this action, a number of antitumor agents (methotrexate, cyclophosphamide, cytarabine, prospidin, etc.) are used in some cases for therapeutic purposes in autoimmune diseases. For allotransplantation of organs and bone marrow transplantation, Kcyclosporin (see), K-azathioprine (see,), glucocorticosteroids are more commonly used.
U Common contraindications to the use of anticancer drugs are severe cachexia, terminal stages of the disease, severe leuko- and thrombopenia.
The question of the use of these drugs during pregnancy is decided individually by U. As a rule, due to the danger of teratogenic action, these drugs during pregnancy are not prescribed; Do not use them also when breastfeeding.
The use of anticancer drugs is made only on prescription by an oncologist.
Recently, some new anticancer drugs have been additionally approved.
The group of drugs used to treat cancer includes drugs: