Internal Medicine: Open Access
Open Access

Navigating the Landscape of Anticancer Drugs: Mechanisms, Administration, and Challenges

John Nicke^{* *}Correspondence: John Nicke, Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA, Email:

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Description

Anticancer drugs, also known as chemotherapy or chemotherapeutic agents, are medications designed to treat cancer by inhibiting the growth and spread of cancer cells. These drugs work through various mechanisms to target cancer cells specifically or interfere with processes necessary for cancer cell survival and proliferation. Here's an overview of anticancer drugs.

Classification

Anticancer drugs can be classified based on their mechanism of action, chemical structure, or the phase of the cell cycle they target.

Common classes of anticancer drugs include alkylating agents, antimetabolites, anthracyclines, topoisomerase inhibitors, mitotic inhibitors, targeted therapies, and immunotherapy agents.

Mechanism of action

Alkylating agents: These drugs work by adding alkyl groups to DNA molecules, interfering with DNA replication and ultimately leading to cell death.

Antimetabolites: Antimetabolites mimic the structure of essential cellular components, such as nucleotides, and disrupt  DNA or RNA synthesis, hindering cancer cell growth.

Anthracyclines: These drugs interfere with DNA replication by inhibiting topoisomerase enzymes or generating free radicals that damage DNA.

Topoisomerase inhibitors: Topoisomerase enzymes play crucial roles in DNA replication and repair. Inhibiting these enzymes prevents DNA unwinding and leads to cell death.

Mitotic inhibitors: These drugs disrupt the process of cell division (mitosis) by targeting microtubules, which are essential for the formation of the mitotic spindle.

Targeted therapies: Targeted therapies aim to selectively target specific molecules or pathways involved in cancer cell growth and survival, such as receptor tyrosine kinases or signaling proteins.

Immunotherapy: Immunotherapy agents harness the body's immune system to recognize and attack cancer cells. Examples include immune checkpoint inhibitors, monoclonal antibodies, and adoptive cell therapies.

Administration

Anticancer drugs can be administered through various routes, including oral tablets, IntraVenous (IV) infusions, intramuscular injections, subcutaneous injections, or intrathecal injections (directly into the cerebrospinal fluid).

The choice of administration route depends on factors such as drug properties, cancer type, treatment goals, and patient preferences.

Side effects

Anticancer drugs often have significant side effects due to their cytotoxic effects on both cancerous and healthy cells.

Common side effects include nausea, vomiting, fatigue, hair loss (alopecia), bone marrow suppression leading to decreased blood cell counts (anemia, leukopenia, thrombocytopenia), gastrointestinal disturbances, and increased susceptibility to infections.

Some targeted therapies and immunotherapy agents may have distinct side effect profiles, such as skin rash, diarrhea, or immune-related adverse events.

Combination therapy

Many anticancer drug regimens involve the use of combination therapy, which combines multiple drugs with different mechanisms of action to target cancer cells more effectively and reduce the risk of drug resistance.

Combination chemotherapy can enhance treatment efficacy by targeting cancer cells through multiple pathways and overcoming heterogeneity within the tumor.

Resistance and overcoming resistance

Cancer cells can develop resistance to anticancer drugs over time, leading to treatment failure and disease progression.

Strategies to overcome drug resistance include adjusting treatment regimens, combining different classes of drugs, developing novel targeted therapies, and addressing tumor microenvironment factors that contribute to resistance. In summary, anticancer drugs are a cornerstone of cancer treatment, aiming to eliminate or control cancer by targeting specific cellular processes involved  in tumor growth and survival. While these drugs have revolutionized cancer care, their use is often associated with significant side effects, and overcoming drug resistance remains a major challenge in cancer treatment. Ongoing research and development efforts continue to refine existing therapies and identify novel approaches to improve outcomes for cancer patients.