Chapter

Pharmacology of anti-cancer drugs

Luis Daverede

Edited by Daniel Swinson

in Colorectal Cancer

Published on behalf of Oxford University Press

ISBN: 9780199590209
Published online May 2012 | e-ISBN: 9780191739675 | DOI: http://dx.doi.org/10.1093/med/9780199590209.003.0005

Series: Oxford Oncology Library

Pharmacology of anti-cancer drugs

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• Fluorouracil (5FU) is an anti-metabolite that was rationally synthesised in the 1960s. The reduction of the pyrimidine ring by dihydropyrimidine dehydrogenase, widely expressed in tissues through out the body, is the rate limiting step dehydrogenase (DPD). Five percent of patients are DPD deficient and experience disproportionate toxicity • Capecitabine, tegafur and S-1 are oral prodrugs which are metabolised to 5FU and other metabolites. The first 2 have at least equal efficacy but better toxicity profiles than bolus 5FU regimens • Oxaliplatin is a member of the platinum family, that although has no recognised single agent activity has synergy with fluoropyrimidines against colorectal cancer. Cumulative neurotoxicity is the dose limiting toxicity • Irinotecan is a topoisomerase I inhibitor with both single agent activity and synergy with fluoropyrimidines against colorectal cancer. Aggressive early use of loperamide is important to prevent profuse diarrhoea • Bevacizumab, cetuximab and panitunumab are monoclonal antibodies, the former targets the vascular endothelial growth factor (VEGF) and is only active in combination with chemotherapy, the latter 2 target epidermal growth factor receptor (EGFR) and have single agent activity and at least an additive effect with chemotherapy against colorectal cancer.

Chapter.  2357 words. 

Subjects: Medical Oncology

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