Chemotherapy

• 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