Types of Oncology Drugs
Immunotherapy Drugs
Immunotherapy drugs work by boosting the body's natural defenses to fight cancer. These include checkpoint inhibitors, monoclonal antibodies, cancer vaccines, and adoptive cell transfer therapies. Checkpoint inhibitors help activate the immune system to target cancer cells. Popular checkpoint inhibitors include Keytruda and Opdivo which are used for the treatment of various cancer types like lung cancer, melanoma, head and neck cancer etc. Monoclonal antibodies are lab-made proteins that bind to cancer cells and mark them for destruction by the immune system. Herceptin, Rituxan are some monoclonal antibody drugs used in cancer treatment. Cancer vaccines aim to stimulate or restore the immune system's ability to fight cancer cells. Sipuleucel-T is an example of a therapeutic cancer vaccine approved for prostate cancer. Adoptive cell transfer therapies involve extracting immune cells from patients, activating them in the lab and transfusing them back to boost the immune response against cancer.
Targeted Therapy Drugs
Targeted therapy Oncology Drugs work by interfering with specific molecules involved in tumor growth and progression. They are designed to target molecular changes in cancer cells that help them grow, divide, and spread. Popular targeted therapies include tyrosine kinase inhibitors, angiogenesis inhibitors, PARP inhibitors, and proteasome inhibitors. Tyrosine kinase inhibitors block signals that tumors need to grow. Imatinib, Erlotinib, Crizotinib are examples. Angiogenesis inhibitors prevent blood vessel growth in tumors to cut off their nutrient supply. Bevacizumab is a well-known angiogenesis inhibitor. PARP inhibitors work by blocking DNA repair in cancer cells with defective BRCA genes. Olaparib is a PARP approved for ovarian and breast cancers. Proteasome inhibitors block tumor cell protein degradation and induce cell death. Bortezomib is approved for multiple myeloma.
Hormonal Therapy Drugs
Hormonal therapy drugs are mainly used in hormone-receptor positive breast and prostate cancers. They slow or stop the growth of cancer by blocking the body's natural hormones or by lowering hormone levels. Common hormonal therapies include selective estrogen receptor modulators, aromatase inhibitors, LHRH agonists or antagonists. Tamoxifen is a selective ER modulator approved for breast cancer. Aromatase inhibitors work by lowering estrogen levels in postmenopausal women. Letrozole, anastrozole are examples. LHRH agonists or antagonists lower testosterone levels in men with prostate cancer. Leuprolide, bicalutamide are approved LHRH therapies. Drugs like fulvestrant are selective ER down-regulators used in advanced breast cancer.
Chemotherapy Drugs
Chemotherapy uses powerful anti-cancer drugs that work throughout the body to destroy rapidly dividing cancer cells. This often forms a key part of treatment for cancers like leukemia, lymphoma, germ cell tumors, multiple myeloma etc. Common classes of chemo drugs include alkylating agents, antimetabolites, antitumor antibiotics, topoisomerase inhibitors. Alkylating agents like cyclophosphamide damage DNA to kill cells. Platinum drugs like cisplatin also damage DNA. Antimetabolites mimic building blocks needed for DNA/RNA synthesis to stop cell growth. Examples are fluorouracil, gemcitabine, methotrexate. Antitumor antibiotics block DNA/RNA synthesis. Doxorubicin, bleomycin are examples. Topoisomerase inhibitors interfere with enzymes involved in DNA unwinding and replication. Etoposide and irinotecan belong to this class. Treatment usually involves a combination of chemo drugs to hit cancer with multiple mechanisms.
Combination Therapies and Future Directions
The future of cancer treatment lies in combining existing oncology drugs and developing new targeted agents. Many ongoing clinical trials are exploring rational drug combinations based on known cancer molecular alterations. A popular approach is combining immunotherapy with targeted drugs or chemotherapy. For instance, combining checkpoint inhibitors like pembrolizumab with chemotherapy improves response rates in head and neck cancer. Combining PARP inhibitors like olaparib with angiogenesis inhibitor cediranib shows benefit in ovarian cancer. Agents targeting new pathways and resistance mechanisms are also under investigation. For example, drugs targeting tumor microenvironment, epigenetic changes, cancer stem cells, bypass signaling pathways hold promise. Development of orally bioavailable drugs, antibody drug conjugates, and personalized neoantigen vaccines can further improve outcomes. With continued industry efforts and clinical research, more effective and customized combination regimens will soon become available to fight many difficult-to-treat cancer types.
In significant progress has been made in the field of oncology drug development in recent years. We now have an array of powerful immunotherapy, targeted, hormonal and chemotherapy drugs to treat various cancer types based on specific molecular traits. Future efforts aim to develop rational combination therapies by leveraging knowledge of cancer genomes and pathways. This coupled with new drug classes holds the key to substantially improve cure rates and quality of life for cancer patients worldwide in the coming decades.
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