Thursday, January 21, 2016

Chemotherapy for Most Common Cancers- Part 1

In part-1 of this series we are focusing on drugs that are used for most common cancer types that are discussed in our most viewed piece "Clinical Diagnosis of Cancer or Cancers"

Figure 1: Commonly diagnosed cancers. It shows estimated cases and
deaths due to these cancers


In our previous discussions, we showed how Oncofinder service introduced by Insilco Inc and Pathway Pharmaceutical helps in identification of chemotherapy drugs for patients on personalised basis. This se
rvice is accessible to patients and doctors. In addition we observed that in many cancer discussion forums there is a great confusion and anxiety about the use of correct chemotherapy.

Moreover, there were flooded with following questions:

a) What type chemotherapy to be used for breast cancer, pancreatic cancer etc.?
b) If "A" molecule worked for a specific person will it work in my case?
c) What are the specific side effect or toxicity of drug?
Figure 2: Word Cloud for Chemotherapy Drugs
d) Is there any alternative to "drug A" if it does not work in a cancer condition?
e) What are the new drugs introduced for cancer therapy?

To answer all these questions we have compiled a list of drugs that are being used for most common type of cancers in table 1. Further, we have also linked it to reliable sources so that readers can cross refer to the authenticated links for more details about side effects and pharmacology of the drugs used. Readers can also click on cancer types to locate the details of the therapies recommended for cancer type.


Most commonly seen side effects of chemotherapy are

a) Weight loss
b) Gastrointestinal abnormalities like diarrhoea and constipation
c) Hair loss
d) Severe muscles fatigue
e) Nausea and vomiting
f) loss of appetite
g) Rashes

In addition to this there are some serious and less common toxicities for specific drugs. We have listed them in the table 1. Readers can also cross check them by clicking on the drug type.

Table 1: Chemotherapy Drug and Its Side Effects


CancerChemotherapy Molecules/ DrugsSevere Side Effects
Bladder Fluorouracil (5-FU)Cardiovascular problems
MitomycinPulmonary fibrosis, pneumonitis, hemolytic uremic syndrome
CisplatinPeripheral neuropathy (nerve damage)
CarboplatinPeripheral neuropathy, central toxicity, hearing loss, infection
DocetaxelPain and buring sensation in hand and feet, sensitivity to cold and heat
DoxorubicinWeaknening of heart muscles causing decrease in blood pumping capacity
Vinblastin
Ifosfamide (Ifex ®)Neurotoxicity and there is a risk of developing leukemia
Permetrexed (ALIMTA ®)Low blood platelet count, flu like symptoms, depression, increase in blood creatinine level
Breast CancerDocetaxel ( Taxotere®)DISCUSSED PREVIOUSLY
PaclitaxelPeripheral neuropathy, allergic reactions, low blood counts, low blood pressure
Cisplatin and CarboplatinDISCUSSED PREVIOUSLY
VinorelbineMuscle weakness
Capecitabine (Xeloda®)Elevated liver enzymes, hand and foot syndrome (Palmar plantar erythrodysesthesia-PPE)
DoxorubicinDISCUSSED PREVIOUSLY
Gemcitabineflu like symptoms, fatigue, blood or protein in urine
MitoxantroneArrythmia, low blood pressure, blue/green discoloration of whites of eyes/ or urine for 1-2 days after treatment
IxabepilonePeripheral neuropathy, weakness, joint pain
Eribulin (Halaven ®)Constipation, muscle pain
Trastuzumab (Herceptin ®)Infection, cold symptoms, body pain
Pertuzumab (Perjeta™)Decreased apetite, fever, muscle weakness, weight gain, upper respiratory track infection
Colon Rectal Cancer5-FUDISCUSSED PREVIOUSLY
Capecitabine (Xeloda®)DISCUSSED PREVIOUSLY
Irinotecan (Camptosar®)Heart burn, dehydration, head ache, flatulence
OxaliplatinPeripheral neuropathy, diarrhea
TrifluridinNeuropathy
Endometrial CancerPaclitaxelDISCUSSED PREVIOUSLY
CarboplatinDISCUSSED PREVIOUSLY
Doxorubicin (Adriamycin ®) DISCUSSED PREVIOUSLY
Doxorubicin liposome (Doxil ®)DISCUSSED PREVIOUSLY
CisplatinDISCUSSED PREVIOUSLY
Ifosfamide (Ifex ®)DISCUSSED PREVIOUSLY
DISCUSSED PREVIOUSLY
Kidney CancerVinblastineFever,extreme fatigue, black or tarry stools, chest pain, presistant headache, urinary retention
FloxuridineStomach ulcers, elevated liver enzyme, PPE, yellowing of skin and eyes
5-FUDISCUSSED PREVIOUSLY
CapecitabineDISCUSSED PREVIOUSLY
GemcitabineDISCUSSED PREVIOUSLY
Interferone alpha (Intron® A, Roferon®-A )Flu like symptoms, fatigue and low blood counts, injection site reaction, liver damage
Nivolumab (Opdivo)Lymphocytopenia, low sodium, potassium, magnesium levels, shortness of breath, pneumonia,
Interleukin 2 (IL-2)Extreme fatigue, low BP, kidney damage, heart attacks, intestinal bleeding, rapid heart beat
Soforanib (Nexavar ®)PPE, high BP, bleeding, increased heart rate, shortness of breath
Sunitinib (Sutent ®)Heart burn, hypertesnsion, increased liver enzyme
Temsirolimus (Torisel ®)Hyperglycemia, increased cholesterol levels, increased liver enzymes, black tarry stools, constipation
Everolimus (Afinitor ®)Anemia, increased cholesterol and triglycerides, black tarry stools
Bevacizumab (Avastin ®)Upper respiratory track infection, proteinuria, gastrointestinal perforations, fistula, hemorrhage, congestive heart failure
Pazopanib (Votrient ®)Hypertension, elevated liver enzymes, bilirubin, extreme fatigue
Axitinib (Iniyta ®)High bloood pressure, kidney disfunction
Leukemia (Chronic Lymphocytic Leukemia)Fludarabine (Fludara ®)Increased risk of infection
Pentostatin (Nipent ®)Easy bruising or bleeding
Cladribine (2-CdA, Leustatin ®)Fatigue
Chlorambucil (Leukeran ®)Tumor lysis syndrome
Cyclophosphamide (Cytoxan ®)Loss of fertility, discoloration of nails
Rituximab (Rituxan ®)Pharyngitis
Bendamustine (Treanda ®)Infertiliy, yellow of skin or eyes
Prednisone Increased apetite, insomnia, heartburn, muscle weakness
MethylprednisoloneAlmost similar to prednisone
DexamethasoneAlmost similar to prednisone
Doxorubicin (Adriamycin ®)DISCUSSED PREVIOUSLY
MethotrexateAlopecia, skin photosensitivity, kidney toxicity
OxaloplatinPeripheral neuropathy
Vincristine (Oncovin ®)Abdominal cramps, peripheral neuropathy, severe abdominal pain, constipation
Etoposide (VP-16)Menopause, loss of fertility, peripheral neuropathy
Cytarabine (ara-C)Skin Rash, blurred visions, dry eyes heart palpitations, chest pain, difficulty to pass urine
Leukemia (Acute Lymphocytic Leukemia)Vincristine (Oncovin ®) or Liposomal vincristine (Marqibo ®)DISCUSSED PREVIOUSLY
Daunorubicin (Daunomycin or Cerubidine ®) or Doxorubicin (Adriamycin ®)DISCUSSED PREVIOUSLY
Cytarabine (Cytocine arabinoside, ara-C or Cytosar ®)DISCUSSED PREVIOUSLY
L-asparaginase (Elspar ®) or PEG-L-asparaginase (pegaspargase or Oncaspar ®)DISCUSSED PREVIOUSLY
Etoposide (VP-16)DISCUSSED PREVIOUSLY
Teniposide (Vumon ®)Infection, shortness of breath, swelling of facial features, rapid heart beat
6-mercaptopurine (6-MP or Purinethol ®)Losss of fertility, hyperpigmentation
MethotrexateDISCUSSED PREVIOUSLY
Cyclophosphamide (Cytoxan ®)DISCUSSED PREVIOUSLY
PrednisoneDISCUSSED PREVIOUSLY
Dexamethasone (Decadrone ®)DISCUSSED PREVIOUSLY
DISCUSSED PREVIOUSLY
Leukemia (Chronic Myeloid Leukemia)Hydroxy urea (hydroxycarbamate, Hydrea ®)Discoloration of skin and nails, fertiilty may be affected
Cytarabine (Ara-C)DISCUSSED PREVIOUSLY
Imatinib (Gleevec ®)Risk of anemia, hemorrhage, heartburn, fertiility may be affected, elevation of transaminase, bilirubin and lactate dehydrogenase
BusulfanLung Damage
Cyclophosphamide (Cytoxan ®)DISCUSSED PREVIOUSLY
Vincristin (Oncovin ®)DISCUSSED PREVIOUSLY
Omacetaxine (Synribo ®)Thromocyteopenia, neutropenia, kidney problems, fever
Non Small Cell Lung CancerCisplatinDISCUSSED PREVIOUSLY
CarboplatinDISCUSSED PREVIOUSLY
Paclitaxel (Taxol ®)DISCUSSED PREVIOUSLY
Albumin- bound Paclitaxel (nab-Paclitaxel, Abraxane ®)DISCUSSED PREVIOUSLY
Docetaxel (Taxotere ®)DISCUSSED PREVIOUSLY
Gemcitabine (Gemzar ®)DISCUSSED PREVIOUSLY
Vinorelbine (Navelbine ®)DISCUSSED PREVIOUSLY
Irinotecan (Camptosar ®)DISCUSSED PREVIOUSLY
Etoposide (VP- 16 ®)DISCUSSED PREVIOUSLY
Vinblastine DISCUSSED PREVIOUSLY
Pemetrexed (Alimta ®)Anemia, increased risk of infection, flu like symptoms, fertility problems
Bevacizumab (Avastine ®)DISCUSSED PREVIOUSLY
Cetuximab (Erbitux ®)Hypersenstivity reactions like shortness of breath, difficulty breathing
Melanoma CancerDacarbazine (also called DTIC)Slight risk of leukemia, fever, low blood counts leading to increased the risk of anemia
TemozolomideCentral neurotoxicity, edema, shortness of breath and other allergic reactions
Nab-paclitaxelDISCUSSED PREVIOUSLY
PaclitaxelDISCUSSED PREVIOUSLY
Carmustine (also known as BCNU)Anemia, low blood pressure, retinal bleeding, pulmonary toxicity, slight risk of blood cancer in long run
CisplatinDISCUSSED PREVIOUSLY
CarboplatinDISCUSSED PREVIOUSLY
VinblastineDISCUSSED PREVIOUSLY
Non Hodgkin LymphomaCyclophosphamide (Cytoxan®)DISCUSSED PREVIOUSLY
ChlorambucilRisk of infection, anemia, leukemia, infertility, pulmonary toxicity
Bendamustine (Treanda®)DISCUSSED PREVIOUSLY
Ifosfamide (Ifex®)DISCUSSED PREVIOUSLY
PrednisoneDISCUSSED PREVIOUSLY
Dexamethasone (Decadron®)DISCUSSED PREVIOUSLY
CisplatinDISCUSSED PREVIOUSLY
CarboplatinDISCUSSED PREVIOUSLY
OxaliplatinDISCUSSED PREVIOUSLY
Fludarabine (Fludara®)Lung problems, infections, anemia
Pentostatin (Nipent®)Muscle ache, itching, cough, anorexia, upper respiratory track infection
Cladribine (2-CdA, Leustatin®)Anemia, myelosuppression, neutropenic fever
Cytarabine (ara-C)DISCUSSED PREVIOUSLY
Gemcitabine (Gemzar®)DISCUSSED PREVIOUSLY
MethotrexateDISCUSSED PREVIOUSLY
Pralatrexate (Folotyn®)Decreased white blood cells, elevated liver enzyme, abdominal pain, upper respiratory track infection, shortness breath
Pancreatic CancerGemcitabine (Gemzar®)DISCUSSED PREVIOUSLY
5-FUDISCUSSED PREVIOUSLY
Irinotecan (Camptosar®)DISCUSSED PREVIOUSLY
Oxaliplatin (Eloxatin®)DISCUSSED PREVIOUSLY
Albumin-bound paclitaxel (Abraxane®)DISCUSSED PREVIOUSLY
Capecitabine (Xeloda®)DISCUSSED PREVIOUSLY
CisplatinDISCUSSED PREVIOUSLY
Paclitaxel (Taxol®)DISCUSSED PREVIOUSLY
Docetaxel (Taxotere®)DISCUSSED PREVIOUSLY
Irinotecan liposome (Onivyde®)DISCUSSED PREVIOUSLY
Erlotinib (Tarceva®) Shortness of breath, coughing, infection, eye irritation
Octreotide (Sandostatin®)Flu like syndrome, abdominal pain, constipation, flu-like syndrome
Lanreotide (Somatuline® Depot),Anemia, effects blood sugar levels
Prostate CancerDocetaxel (Taxotere®)Allergic reactions and peripheral neuropathy
Cabazitaxel (Jevtana®)Allergic reactions and peripheral neuropathy
Mitoxantrone (Novantrone®)Can cause leukemia several years later
Estramustine (Emcyt®)Increased risk of blood clot formation
Doxorubicin (Adriamycin®)DISCUSSED PREVIOUSLY
Etoposide (VP-16)DISCUSSED PREVIOUSLY
Vinblastine (Velban®)DISCUSSED PREVIOUSLY
Paclitaxel (Taxol®)DISCUSSED PREVIOUSLY
Carboplatin (Paraplatin®)DISCUSSED PREVIOUSLY
Vinorelbine (Navelbine®)DISCUSSED PREVIOUSLY
Thyroid CancerTositumomab and Radioactive Iodine (RAI) (Bexxar ®)Low blood pressure, cough, soar throat, hyopthyrodism, aches and pain

thyroid hormone (levothyroxine) pillsExtreme fatigue, chest pain, eye pain, dizziness    

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Signal Transduction Pathways

Signal Transduction Pathways
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