antineoplastic

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antineoplastic

 [an″te-, an″ti-ne″o-plas´tik]
inhibiting the maturation and proliferation of malignant cells.
antineoplastic agent.
antineoplastic therapy a regimen that includes chemotherapy, aimed at destruction of malignant cells using a variety of agents that directly affect cellular growth and development. Chemotherapy is but one of a variety of methods available in the treatment of cancer. Cancers particularly responsive to chemotherapy include choriocarcinoma, a highly malignant form of cancer that originates in the placenta; testicular carcinoma; and burkitt's lymphoma, a malignancy most often found in African children. Combinations of drugs have successfully controlled acute leukemia in children and in persons with advanced stages of hodgkin's disease.
Types of Antineoplastic Agents. The chemicals and drugs used in the treatment of cancer may be divided into several main groups. The first group, the alkylating agents, are capable of damaging the DNA of cells, thereby interfering with the process of replication; they are cell cycle phase nonspecific. Among these are busulfan, cyclophosphamide, ifosfamide, and thiotepa; the nitrogen mustardschlorambucil, mechlorethamine, and melphalan; and the nitrosoureascarmustine, lomustine, semustine, and streptozocin.

The second group of drugs is the antimetabolites; as the name suggests, they interfere with the cancer cell's metabolism. Some replace essential metabolites without performing their functions, while others compete with essential components by mimicking their functions and thereby inhibiting the manufacture of protein in the cell. Antimetabolites are cell cycle phase specific (S phase). Included in this group are capecitabine, cladribine, cytarabine, floxuridine, fludarabine, fluorouracil, mercaptopurine, methotrexate, and thioguanine.

The third group is the antitumor antibiotics. These agents have been isolated from microorganisms and affect the function and/or synthesis of nucleic acids; they are cell cycle phase nonspecific. This group includes bleomycin sulfate, dactinomycin, daunorubicin, doxorubicin, epirubicin, idarubicin, mitomycin, mitoxantrone, pentostatin, plicamycin, and streptozocin.

The fourth group is the alkaloids; the most important of which are the vinca alkaloids. They are cell cycle phase specific, exerting their effect during the M phase of cell mitosis and causing metaphase arrest. Included in this group are vinblastine, vincristine, vindesine, and vinorelbine tartrate.

The fifth group is the hormones and antihormones, which create an unfavorable environment for cancer cell growth. Hormones used in antineoplastic therapy include estrogens, androgens, progestins, and corticosteroids. antihormones include aminoglutethimide, chlorotrianisene, flutamide, goserelin, leuprolide, and tamoxifen.

There are a variety of other drugs, some whose mechanisms of action are known and others for whom the mechanism is unknown. Plant derivatives include the podophyllotoxin derivatives etoposide and teniposide, as well as paclitaxel, a derivative of the Pacific yew tree. Platinum coordination compounds include carboplatin and cisplatin. Other agents include asparaginase, dacarbazine, hydroxyurea, the interferons, levamisole, mitotane, procarbazine, and tretinoin.
Patient Care. The drugs used in antineoplastic therapy are highly toxic and likely to produce troublesome or even extremely dangerous reactions; they should be administered only by qualified professionals. They may be given singly or in combination, depending on the type of malignancy and the stage of its development. The complexity of this type of therapy, particularly when used in conjunction with surgery or radiation therapy, demands a team of specialists, including medical oncologists, radiotherapists, nurse clinicians, and clinical pharmacologists, working cooperatively to accomplish the goals of the prescribed regimen.

It is especially important that members of the team be aware of and capable of dealing with the toxicity inherent in antineoplastic therapy. The management of drug toxicities requires a delicate balance between effective dosage to destroy malignant cells and the individual patient's tolerance of drug and dosage. Anorexia, nausea, and vomiting are among the milder but more troublesome effects of antibiotics, alkylating agents, and antimetabolites. It is necessary to work with each patient and help establish a routine that will incorporate administration of the drug, taking an antiemetic, and spacing meals so that adequate nutrition is provided and excessive weight loss is avoided. Stomatitis and diarrhea are also likely to appear as early signs of toxicity from antimetabolic and antibiotic drug therapy.

Drugs that suppress bone marrow function produce leukopenia, which in turn increases susceptibility to infection. If the patient is also receiving an immunosuppressant such as prednisone, resistance to infection is further compromised. The patient will need adequate rest, good nutrition, good habits of personal cleanliness, and avoidance of contact with those who have infectious diseases. If an infection does develop, it should receive prompt attention to minimize its effects and inhibit its progress. It may be necessary to alter the dosage of the antineoplastic drug until the infection subsides.

Bone marrow-suppressing drugs can also affect the platelet count, reducing it to a level at which bleeding can readily occur. Normal clotting is impaired by some cancer therapeutic agents and there is therefore the danger of internal bleeding anywhere in the body. Should the situation become severe, the drug dosage may need to be reduced or stopped altogether and platelet transfusions may be given.

Hormonal therapy frequently is accompanied by fluid retention. Measurement of intake and output, daily weight measurement, and observation for signs of surface edema or congestive heart failure are essential parts of patient care. Care of the patient with edema must include meticulous skin care. If diuretics are given, the patient must be watched for signs of potassium depletion. Another side effect of hormonal therapy may be changes in secondary sexual characteristics. These can be particularly embarrassing and emotionally disturbing to the patient.

Neurologic disorders may result from treatment with the plant alkaloids. These conditions may manifest themselves as impaired sensation, loss of coordination, and severe constipation. Although these neurological effects usually are reversible, especially if caught in the early stages, it may take months for the nerve cells to recover and resume normal function.

Many antineoplastic drugs cause alopecia (hair loss). This side effect can drastically alter the patient's body image and can be very disturbing psychologically. Wigs, hairpieces, and various head coverings can be used to mask the hair loss.

an·ti·ne·o·plas·tic

(an'tē-nē'ō-plas'tik),
Preventing the development, maturation, or spread of neoplastic cells.

antineoplastic

/an·ti·neo·plas·tic/ (-ne″o-plas´tik)
1. inhibiting or preventing development of neoplasms; checking maturation and proliferation of malignant cells.
2. an agent that so acts.

antineoplastic

(ăn′tē-nē′ə-plăs′tĭk, ăn′tī-)
adj.
Inhibiting or preventing the growth or development of malignant cells.

an′ti·ne′o·plas′tic n.

antineoplastic

[-nē′ōplas′tik]
Etymology: Gk, anti + neos, new, plasma, something formed
1 pertaining to a substance, procedure, or measure that prevents the proliferation of cells.
2 a chemotherapeutic agent that controls or kills cancer cells. Drugs used in the treatment of cancer are cytotoxic but are generally more damaging to dividing cells than to resting cells. Cycle-specific antineoplastic agents are more effective in killing proliferating cells than resting cells, and phase-specific agents are most active during a specific phase of the cell cycle. Most anticancer drugs prevent the proliferation of cells by inhibiting the synthesis of deoxyribonucleic acid (DNA) by various mechanisms. Alkylating agents, such as mechlorethamine HCl derivatives, ethylenimine derivatives, and alkyl sulfonates, interfere with DNA replication by causing cross-linking of DNA strands and abnormal pairing of nucleotides. Antimetabolites exert their action by interfering with the formation of compounds required for cell division. Methotrexate, folic acid analog, and 5-fluorouracil, a pyrimidine analog, inhibit enzymes required for the formation of the essential DNA constituent thymidine. 6-Mercaptopurine, a hypoxanthine analog, and 6-thioguanine, an analog of guanine, interfere with the biosynthesis of purines. VinBLAStine sulfate and vinCRIStine sulfate, alkaloids derived from the periwinkle plant, disrupt cell division by interfering with the formation of the mitotic spindle. Antineoplastic antibiotics, such as DOXOrubicin HCl, daunomycin, and mitomycin, block or inhibit DNA synthesis; dactinomycin and plicamycin interfere with ribonucleic acid synthesis. Cytotoxic chemotherapeutic agents may be administered via the oral or intravenous route or by infusion. All have untoward and unpleasant side effects and are potentially immunosuppressive and dangerous. Estrogens and androgens, although not considered antineoplastic agents, frequently cause tumor regression when administered in high doses to patients with hormone-dependent cancers.

antineoplastic

adjective Referring to an agent or mechanism that lyses or inhibits tumours.

noun An agent that attenuates, kills or inhibits tumour growth.

antineoplastic

adjective Referring to an antineoplastic agent or mechanism noun Chemotherapeutic agent, see there.

an·ti·ne·o·plas·tic

(an'tē-nē'ō-plas'tik)
Preventing the development, maturation, or spread of neoplastic cells.

antineoplastic

Able to control the growth or spread of cancers (neoplasms).

Antineoplastic

A drug used to inhibit the growth and spread of cancerous cells.
Mentioned in: Priapism

an·ti·ne·o·plas·tic

(an'tē-nē'ō-plas'tik)
Preventing the development, maturation, or spread of neoplastic cells.

antineoplastic

1. inhibiting the maturation and proliferation of malignant cells.
2. an agent having such properties.

antineoplastic therapy
a regimen of treatment aimed at destruction of malignant cells and utilizing a variety of chemical agents that directly affect cellular growth and development.
The chemicals and drugs used in the treatment of cancer may be divided into three groups. The first group, the alkylating agents, are capable of damaging the DNA of cells, thereby interfering with the process of replication. Among these drugs are chlorambucil, cyclophosphamide, mustine hydrochloride and triethylene thiophosphamide (thiotepa). The antibiotic actinomycin D (dactinomycin) is also included in this group.
The second type of drugs used in cancer chemotherapy are the antimetabolites. As the name suggests, these drugs interfere with the cancer cell's metabolism. Some replace essential metabolites without performing their function, while others compete with essential components by mimicking their functions and thereby inhibiting the manufacture of protein in the cell. Included in this group are cytosine arabinoside, floxuridine (FUDR), 5-fluorouracil (5-FU), mercaptopurine (6-MP), methotrexate and thioguanine.
The third group of chemicals employed in the treatment of cancer are 'natural products' that directly affect the mechanism of cell division. The plant alkaloids, e.g. vincristine and vinblastine, stop cell division at metaphase (a subphase in cell mitosis). The enzymes, e.g. L-asparaginase, starve tumor cells by catabolizing substances (e.g. asparagine) which they need for survival. Hormones change cell metabolism by making the cellular environment unfavorable for growth of certain tumors.
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