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6. Basic concepts of chemotherapy

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  • Polychemotherapy = simultaneous use of multiple chemo drugs
    • The term is not consistently used, even by me
    • Recently, we have moved to preferring to use multiple chemo drugs, so the term is kind of reduntant
  • Mode of actions
    • Induce DNA damage
    • Inhibit DNA repair mechanisms
    • Inhibit metabolism
      • For example nucleotide synthesis
    • Inhibit mitosis
    • Inhibit neo-vascularization
  • Commonly used drugs
    • Platinum-based drugs
      • Cisplatin
        • Very nephrotoxic – renal function must be measured before use
      • Carboplatin
        • Less nephrotoxic – sometimes used as an alternative to cisplatin in case of poor kidney function
    • 5-Fluorouracil (FU)
    • Taxanes
      • Paclitaxel
      • Docetaxel
  • Commonly used regimens
    • FLOT
      • 5-FU
      • Leucovorin
      • Oxaliplatin
      • DoceTaxel
    • FOLFOX
      • FOLinic acid (leucovorin)
      • 5-FU
      • Oxaliplatin
    • FOLFIRI
      • FOLinic acid
      • 5-FU
      • IRInotecan
    • ECX
      • Epirubicin
      • Cisplatin
      • Capecitabine
    • Gem/cis
      • Gemcitabine + cisplatin
    • XELOX
      • Capecitabine + oxaliplatin