Antineoplastic

Antineoplastics (or "antitumor antibiotics", or "noncovalent DNA-binding drugs", or "cytotoxic antibiotics", see also neoplastics) are drugs that inhibit and combat the development of tumors.

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In the Anatomical Therapeutic Chemical Classification System, they are classified under L01D.

Health Effects/Occupational Exposure

The adverse health effects associated with antineoplastic agents (cancer chemotherapy drugs, cytotoxic drugs) in cancer patients and some non-cancer patients treated with these drugs are well-documented. The very nature of antineoplastic agents makes them harmful to healthy cells and tissues, as well as the cancerous cells. For cancer patients with a life-threatening disease, there is a great benefit to treatment with these agents. However, for the healthcare workers that are exposed to antineoplastic agents as part of their work practice, precautions should be taken to eliminate or reduce exposure as much as possible. Pharmacists that prepare these drugs or nurses that may prepare and/or administer them are the two occupational groups with the highest potential exposure to antineoplastic agents. In addition, physicians and operating room personnel may also be exposed through the treatment of patients. Hospital staff, such as shipping and receiving personnel, custodial workers, laundry workers, and waste handlers, all have potential exposure to these drugs during the course of their work. The increased use of antineoplastic agents in veterinary oncology also puts these workers at risk for exposure to these drugs.^[1]

Modes of action

Antineoplastics work by:

• Inhibiting topoisomerase II, thereby stopping DNA from being unwound, which is required for both DNA replication and RNA/protein synthesis.
• Generating free radicals.

They are products of various strains of the soil bacteria Streptomyces.

Examples

• actinomycin (L01DA01).
  • The most important immunosuppressant from this group is dactinomycin, which is used to in kidney transplantations.
• anthracyclines
  • doxorubicin (L01DB01)
  • daunorubicin (L01DB02)
  • epirubicin (L01DB03), which also inhibit topoisomerase II)
• other cytotoxic antibiotics
  • bleomycin (L01DC01). Bleomycin acts in unique way through oxidation of a DNA-bleomycin-Fe(II) complex and forming free radicals, which induce damage and chromosomal aberrations.
  • plicamycin (L01DC02)
  • mitomycin (L01DC03)