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Chemotherapy is a treatment approach that uses drugs to target and kill rapidly dividing cells, primarily cancer cells. However, because many normal cells also divide quickly (such as those in the bone marrow, digestive tract, and hair follicles), chemotherapy can also affect these cells, leading to a range of side effects.
Main Classes of Chemotherapy Agents and Examples
Alkylating Agents:
-work by adding alkyl groups to DNA, which interferes with the DNA’s structure and prevents replication.
Examples: Cyclophosphamide, Ifosfamide, Melphalan, Chlorambucil, Busulfan.
Anti-metabolites:
-interfere with DNA and RNA synthesis by substituting for the normal building blocks of nucleic acids.
Examples: Methotrexate, 5-Fluorouracil (5-FU), Cytarabine, Gemcitabine, 6-Mercaptopurine.
Anti-microtubule Agents:
-interfere with the structures that separate chromosomes during cell division (mitosis).
Examples: Paclitaxel, Docetaxel, Vincristine, Vinblastine.
Topoisomerase Inhibitors:
-target the enzymes topoisomerase I and II, which control the changes in DNA structure required for replication.
Examples: Etoposide (topoisomerase II inhibitor), Irinotecan (topoisomerase I inhibitor), Topotecan.
Cytotoxic Antibiotics:
-intercalate into DNA, inhibiting the replication of cancer cells.
Examples: Doxorubicin, Daunorubicin, Bleomycin, Mitoxantrone.
Platinum-Based Agents:
-contain platinum and cause cross-linking of DNA, which interferes with DNA repair and replication.
Examples: Cisplatin, Carboplatin, Oxaliplatin.
Many chemotherapy agents exert their effects, at least in part, by inducing oxidative stress in cancer cells. They can increase ROS levels through several mechanisms:
-Direct generation of free radicals.
-Disruption of mitochondrial function, leading to increased production of ROS.
-Interference with the cell’s antioxidant systems.
-May want to avoid antioxidants 7 days bef ore and 7 days after chemo.
Examples: NAC, Glutathione, Alpha Lipoic Acid, Vitamin E
-anti-oxidants known to have pro-oxidant effects (like Quercetin, Curcumin, etc.) should not be taken 2-3 days before and after chemo
-pro-oxidants known to bring good benefit to chemo can be continued during chemo. Examples are: Omega 3, Aremisia Annua, Silver NanoParticles.