What Are Antineoplastic Agents?

Anti-tumor drugs are a class of drugs used to treat tumor diseases. In short, there are chemotherapy drugs and biological agents. In recent years, the development of molecular oncology and molecular pharmacology has gradually clarified the nature of tumors; the invention and application of advanced technologies such as large-scale rapid screening, combinatorial chemistry, and genetic engineering have accelerated the development of drugs; research and development of anti-tumor drugs have Enter a brand new era.

Anti-tumor drugs are a class of drugs used to treat tumor diseases. In short, there are chemotherapy drugs and biological agents. In recent years, the development of molecular oncology and molecular pharmacology has gradually clarified the nature of tumors; the invention and application of advanced technologies such as large-scale rapid screening, combinatorial chemistry, and genetic engineering have accelerated the process of drug development; research and development of anti-tumor drugs have Enter a brand new era.

Chinese name

Antitumor drugs

Types of

Chemotherapy drugs

Attributes

drug

Use

Antitumor

Antitumor Drugs I. Introduction to Antitumor Drugs

Anti-tumor drugs are a class of drugs used to treat tumor diseases. In recent years, the development of molecular oncology and molecular pharmacology has gradually clarified the nature of tumors; the invention and application of advanced technologies such as large-scale rapid screening, combinatorial chemistry, and genetic engineering have accelerated the process of drug development; research and development of anti-tumor drugs have Enter a brand new era. The current development strategies of anti-tumor drugs have the following points: (1) target solid tumors that account for more than 90% of malignant tumors; (2) look for active ingredients from natural products; (3) target the mechanism of tumorigenesis and development, Find new molecular targets (enzymes, receptors, genes, etc.); (4) High-through put screening; (5) Introduction and application of new technologies: combinatorial chemistry, structural biology, computers Aided design, genetic engineering, DNA chip, pharmacogenomics (combination of functional genomics and pharmacology), etc. ^[1]

Antitumor Drugs 2. Research and Development Background

According to World Health Organization (WHO) statistics, 3 out of 5 people worldwide die from four major diseases: cancer, diabetes, cardiovascular disease, and chronic respiratory disease. Cancer is one of the leading causes of death. In 2008, 7.6 million people died of cancer worldwide, accounting for 13% of the global deaths. More than 70% of cancer deaths occurred in low- and middle-income countries. It is predicted that by 2030, more than 1.1 million people will die worldwide. cancer.

And the results of the third national cause-of-death survey by the Ministry of Health show that cancer is the second leading cause of death in China after cardiovascular and cerebrovascular diseases, accounting for 22.32% of the total deaths, and the first cause of death in Chinese cities, accounting for the number of deaths in urban China. 1/4. The cancer mortality rate in China is close to that of the United States, Britain, and France, but higher than that of Asian countries (such as Japan, India, and Thailand). From the perspective of different tumor death causes, the mortality rates of lung cancer, colorectal cancer, pancreatic cancer, and breast cancer were significantly higher in rural areas than in rural areas; while liver cancer, gastric cancer, esophageal cancer, and cervical cancer were higher in rural areas.

At present, drug therapy has become one of the important means for clinical treatment of tumors. Due to the high incidence and mortality of cancer, the sales of anti-tumor drugs have also increased year by year ^[2-3] .

Antitumor drugs III. Drug classification

At present, there are about 80 common antitumor drugs in the world, which can be roughly divided into the following six categories: cytotoxic drugs, hormone drugs, biological response modifiers, monoclonal antibody drugs, other drugs, and adjuvant drugs ^{[4 ]} .

1. Cytotoxic drugs

(1) Drugs acting on the chemical structure of DNA

Alkylating agents and nitrogen mustards (such as: nitrogen mustard, phenylbutyric acid nitrogen mustard, cyclophosphamide, ifosfamide, melphalan, etc.), thiotepines (such as: thiotepine, etc.), nitrous acid Urine (such as: Carmustine, Slimostatin, etc.) and Mesylate (such as Busulfan, etc.)

Platinum compounds (such as cisplatin, carboplatin and platinum oxalate, etc.)

Mitomycin (such as: Mitomycin, etc.)

(2) Drugs affecting nucleic acid synthesis

Dihydrofolate reductase inhibitors (such as methotrexate, pemetrexed, etc.)

Thymosine synthase inhibitors (such as 5-FU, FT-207, capecitabine, etc.)

Purine nucleotide synthetase inhibitors (such as 6-mercaptopurine, 6-TG, etc.)

Nucleotide reductase inhibitors (such as hydroxyurea, etc.)

DNA polymerase inhibitor (such as cytarabine, gemcitabine, etc.)

(3) Drugs acting on nucleic acid transcription

Drugs that selectively act on DNA templates and inhibit DNA-dependent RNA polymerases to inhibit RNA synthesis (eg, actinomycin D, daunorubicin, doxorubicin, epirubicin, aclanomycin, radiance (Mycin, etc.)

(4) Topoisomerase I inhibitors acting on DNA replication (eg, irinotecan, topocan, hydroxycamptothecin, etc.)

(5) Drugs that mainly interfere with tubulin synthesis during M phase of mitosis (eg, paclitaxel, docetaxel, vinblastine, norvinblastine, podophylline, homoharringtonine, etc.)

(6) other cytotoxic drugs (such as asparaginase)

2. Hormones

(1) Anti-estrogens (such as tamoxifen, toremifene, exemestane, etc.)

(2) Aromatase inhibitors (such as aminophenidone, formestane, letrozole, anastrozole, etc.)

(3) Progestins (such as megestrol, megestrol, etc.)

(4) Sex hormones (eg: methyltestosterone, testosterone propionate, diethylstilbestrol, etc.)

(5) Anti-androgens (such as flutamide)

(6) RH-LH agonist / antagonist (such as goserelin, leuprolide acetate, etc.)

3. Biological response modifiers

Suppress tumors mainly through the body's immune function

(1) Interferon

(2) Interleukin-2

(3) Thymosin

4. Monoclonal antibody drugs (such as rituximab injection, trastuzumab for injection, bevacizumab, etc.)

5. Other drugs

Includes some drugs for which the mechanism is currently unknown and for further study

(1) Cell differentiation inducer (such as retinoids, arsenite, etc.)

(2) Apoptosis inducer

(3) neovascularization inhibitor

(4) Epidermal growth factor receptor inhibitors (such as gefitinib, erlotinib, etc.)

(5) Gene therapy

(6) Tumor vaccine

6, auxiliary drugs

An important adjuvant in cancer treatment

(1) Blood-raising drugs (such as: G-CSF, GM-CSF, interleukin-11, EPO, etc.)

(2) Antiemetic drugs (such as ondansetron, granisetron hydrochloride, etc.)

(3) Analgesics (such as aspirin, paracetamol, codeine, tramadol, morphine, fentanyl, etc.)

(4) Drugs that inhibit osteoclasts (such as disodium clodronate, disodium pamidronate, etc.)

Antitumor Drugs

After years of development, many important advances have been made in the development of antitumor drugs. However, in the face of the most serious solid tumors that threaten human life and health, accounting for more than 90% of malignant tumors, there is still a lack of highly effective and specific drugs. The development of anti-tumor drugs also requires the application of new ideas, technologies and methods.

The progress of anti-tumor drugs meets the requirements for the development of anti-tumor drugs and lays the foundation for individualized treatment. It shows a new era of anti-tumor drug development: molecular targeted drugs have improved the efficacy of some chemotherapy-resistant tumors. Sexuality also has certain advantages. The combination with chemotherapy and radiotherapy, as well as the combination between targeted drugs, is expected to further improve the efficacy. This research concept has penetrated into all areas of anti-tumor drug development worldwide, laying the foundation for providing highly selective, efficient and low-toxic drugs. At the same time, the research on biomarkers is getting more and more attention, which not only helps the therapeutic application of anti-tumor drugs, but also promotes the in-depth development of anti-tumor drugs. In addition, the development of new therapeutic drugs such as anti-tumor vaccines has further enriched the treatment methods. On this basis, with the development of chip technology and bioinformatics technology, tumor cells can be accurately classified (molecular typing) at the gene structure and expression level. Based on this, it has become possible to guide individualized targeted therapy. The combination of molecular targeting drugs with other drugs to maximize the efficacy of anti-tumor ^[5] .