Types of Drugs
Below is a list of some types of anticancer drugs used to treat blood cancers. Some of these drugs are often combined with each other for treatment. This list doesn't include every drug approved for blood cancers nor does it include drugs being studied in clinical trials.
Antimetabolites
Antimetabolites mimic the building blocks of DNA or RNA that cancer cells need to survive and grow. When the cancer cell uses an antimetabolite instead of the natural substances, it can't produce normal DNA or RNA and the cell dies. Examples include:
- cladribine (Leustatin®)
- clofarabine (Clolar®)
- cytarabine (cytosine arabinoside, ara-C, Cytosar-U®)
- fludarabine (Fludara®)
- hydroxyurea (Droxia®, Hydrea®)
- mercaptopurine (6-MP, Purinethol®)
- methotrexate (Rheumatrex®, Trexall®)
- pralatrexate (Folotyn®)
- 6-thioguanine (thioguanine, Tabloid®)
Antimitotics
Antimitotics damage cancer cells by blocking a process called mitosis (cell division), which prevents cancer cells from dividing and multiplying. Examples include:
- vinblastine (Velban®)
- vincristine (Oncovin®)
Antitumor Antibiotics
Antitumor antibiotics prevent cell division by either binding to DNA to prevent the cells from duplicating or inhibiting RNA synthesis. Examples include:
- bleomycin (Blenoxane®)
- daunorubicin (Cerubidine®)
- doxorubicin (Adriamycin®, Doxil®)
- idarubicin (Idamycin®)
- mitoxantrone (Novantrone®)
Bisphosphonates
Bisphosphonates are used to treat high levels of calcium in the blood caused by certain cancers, including myeloma. Bisphosphonates won't slow or stop the spread of cancer, but they can slow bone breakdown, increase bone thickness and reduce bone pain and fracture risk. Examples include:
- pamidronate (Aredia®)
- zoledronic acid (Zometa®)
Cell-Maturing Agents
Cell-maturing agents cause leukemia cells to mature. Examples include:
- arsenic trioxide (Trisenox®)
- tretinoin (all-trans retinoic acid [ATRA], Vesanoid®)
DNA-Damaging Agents (Antineoplastics) and Alkylating Agents
DNA-damaging agents (antineoplastics) and alkylating agents react with DNA to change it chemically and keep it from allowing cell growth. Examples include:
- bendamustine (Treanda®)
- busulfan (Busulfex®, Myleran®)
- carboplatin (Paraplatin®)
- carmustine (BCNU, BiCNU®)
- chlorambucil (Leukeran®)
- cisplatin (Platinol®-AQ)
- cyclophosphamide (Cytoxan®)
- dacarbazine (DTIC-Dome®)
- denileukin diftitox (Ontak®)
- ifosfamide (Ifex®)
- lomustine (CCNU, CeeNU®)
- mechlorethamine (nitrogen mustard, Mustargen®)
- melphalan (Alkeran®)
- procarbazine (Matulane®)
DNA-Repair Enzyme Inhibitors
DNA-repair enzyme inhibitors attack the cancer cell proteins (enzymes) that normally repair damage to DNA. DNA repair is a normal and vital process within the cell. Without this repair process, the cancer cell is much more susceptible to damage and is prevented from growing. Examples include:
- etoposide (VP-16, Etopophos®, Toposar®, VePesid®)
- teniposide (VM-26, Vumon®)
- topotecan (Hycamtin®)
Enzymes
Some enzymes can prevent cancer cells from surviving. Examples include:
- asparaginase (Elspar®)
- pegaspargase (Oncaspar®)
Histone Deacetylase Inhibitors
Histone deacetylase inhibitors attack cancer cells by targeting the proteins that support DNA in the cell nucleus. Examples include:
- romidepsin (Istodax®)
- vorinostat (Zolinza®)
Hormones (Corticosteroids)
Certain hormones (corticosteroids) can kill lymphocytes. They're thought to work by blocking cell metabolism through their effect on specific genes. However, the way these drugs work is under study. In high doses, these synthetic hormones, relatives of the natural hormone cortisol, can kill malignant lymphocytes. Examples include:
- dexamethasone (Decadron®)
- methylprednisolone (Medrol®)
- prednisone
Hypomethylating (Demethylating) Agents
Hypomethylating (demethylating) agents interfere with cancer cell duplication by slowing or reversing hypermethylation. Methylation is a critical part of cell growth and replication. This process sometimes speeds up in cancer cells. Examples include:
- azacitidine (Vidaza®)
- decitabine (Dacogen®)
Azacitidine and decitabine are also referred to as "antimetabolites."
Immunomodulators
Immunomodulators are based on natural products. Experts don't fully understand how they work but suspect they may change or influence immune system function. Immune modulators may suppress or stimulate immune response. Examples include:
- interferon alfa-2a (Roferon®-A)
- interferon alfa-2b (Intron® A)
- lenalidomide (Revlimid®)
- thalidomide (Thalomid®)
Monoclonal Antibodies
Monoclonal antibodies are laboratory-produced proteins that target specific antigens on the cancer cell's surface to interfere with the cell's function and destroy it. Some monoclonal antibodies are combined with a toxin or radioactive substance. Examples include:
- alemtuzumab (Campath®)
- ibritumomab tiuxetan (Zevalin®)
- ofatumumab (Arzerra®)
- rituximab (Rituxan®)
- tositumomab and iodine I 131 tositumomab (Bexxar®)
Proteasome Inhibitors
Proteasome inhibitors are designed to limit the effects of a cell structure called a proteasome. When a proteasome doesn't function properly, the cell dies. Cancer cells may be more susceptible to the effects of proteasome inhibition than normal cells may be. An example is bortezomib (Velcade®).
Tyrosine Kinase Inhibitors
Tyrosine kinase inhibitors block the action of a specific, abnormal protein that signals cancer cells to grow. Examples include:
- dasatinib (Sprycel®)
- imatinib mesylate (Gleevec®)
- nilotinib (Tasigna®)
