What are chemotherapy drugs?
Chemotherapy drugs are the medicines used during chemotherapy, or “chemo.” Chemotherapy is one of the most common and effective cancer treatments available. It destroys fast-growing cells, like cancer cells, and prevents them from multiplying.
Cells — including cancer cells and healthy cells — reproduce during a process called the cell cycle. During the cycle, a cell copies its genetic material (DNA) and divides to form new cells. Healthy cells reproduce when needed and die when they’re no longer useful (apoptosis). Cancer cells, on the other hand, don’t die. Instead, they multiply out of control and form tumors that can damage healthy tissue.
Chemotherapy drugs interfere with the cell cycle, killing cancer cells and preventing them from making more cancer cells. Various chemotherapy drugs use different methods to disrupt the cell cycle and fight cancer.
What do chemotherapy drugs treat?
Chemotherapy drugs are primarily used to treat cancer. Cancer specialists called medical oncologists often prescribe chemotherapy drugs, in addition to other cancer treatments — like surgery, radiation therapy, immunotherapy or targeted therapy — to fight cancer.
Chemotherapy drugs may be used to treat conditions other than cancer, including:
- Autoimmune diseases: With an autoimmune disease, cells in your immune system attack healthy tissue in your body. By preventing cells from multiplying, chemotherapy can slow the immune cells harming your body.
- Blood disorders: Blood disorders include conditions that involve your bone marrow making abnormal blood cells. With certain blood disorders, you may need a stem cell transplant to replace abnormal blood cells with healthy ones. Chemotherapy is often given before a transplant to destroy abnormal cells and make room for healthy cells.
How common are chemotherapy drugs?
Chemotherapy, surgery and radiation are the three most common cancer treatments. According to the Centers for Disease Control and Prevention (CDC), about 650,000 people with cancer receive chemotherapy in an outpatient cancer treatment setting in the U.S. each year.
What are the drugs used in chemotherapy?
Chemotherapy drugs are grouped based on their composition (what they’re made of) and how they destroy cancer cells. Some types of chemotherapy drugs work most effectively during specific phases of the cell cycle, while others kill cancer cells at all phases.
Your oncologist will consider the best timing to administer a chemotherapy drug and the optimal dosage when they plan your treatment.
You may receive one type of chemotherapy drug or a combination of drugs. This is called combination chemotherapy. Using more than one type of chemotherapy drug can increase treatment effectiveness, as different drug types target cancer cells differently. Also, using drugs in combination can reduce the likelihood of your body becoming resistant to a specific drug. Once you develop a resistance, the drug may no longer work as a cancer treatment.
Alkylating agents (including nitrosoureas)
What they do: Alkylating agents damage cell DNA to prevent cancer cells from dividing. Nitrosoureas are a particular type of alkylating agent. Unlike other alkylating agents, nitrosoureas can travel into your brain and kill cancer cells there. Nitrosoureas are used to treat some brain tumors.
Selected alkylating agents include:
- Altretamine.
- Bendamustine.
- Busulfan.
- Carboplatin.
- Chlorambucil.
- Cisplatin.
- Cyclophosphamide.
- Dacarbazine.
- Ifosfamide.
- Mechlorethamine.
- Melphalan.
- Oxaliplatin.
- Procarbazine.
- Temozolomide.
- Thiotepa.
- Trabectedin.
Selected nitrosoureas include:
- Carmustine.
- Lomustine.
- Streptozocin.
Antimetabolites
What they do: Antimetabolites prevent cancer cells from making the genetic material they need to create new cells.
Selected antimetabolites include:
- 5-fluorouracil.
- 6-mercaptopurine.
- Azacitidine.
- Capecitabine.
- Cladribine.
- Clofarabine.
- Cytarabine.
- Decitabine.
- Floxuridine.
- Fludarabine.
- Gemcitabine.
- Hydroxyurea.
- Methotrexate.
- Nelarabine.
- Pemetrexed.
- Pentostatin.
- Pralatrexate.
- Thioguanine.
- Trifluridine/tipiracil combination.
Topoisomerase inhibitors
What they do: Topoisomerase inhibitors prevent an enzyme called topoisomerase from allowing DNA to copy itself. Stopping this enzyme prevents cancer cells from multiplying and can also damage the cell DNA.
Selected topoisomerase inhibitors include:
- Etoposide.
- Irinotecan.
- Irinotecan liposomal.
- Mitoxantrone (also classified as an antitumor antibiotic, see below).
- Teniposide.
- Topotecan.
Mitotic inhibitors (plant alkaloids)
What they do: Mitotic inhibitors are also called plant alkaloids because they’re made of the same material plants use to protect against predators. These drugs work by interfering with a cancer cell’s ability to divide and make new cells, a process called mitosis.
Selected mitotic inhibitors include:
- Cabazitaxel.
- Docetaxel.
- Nab-pacl*taxel.
- Pacl*taxel.
- Vinblastine.
- Vincristine.
- Vincristine liposomal.
- Vinorelbine.
Antitumor antibiotics (including anthracyclines)
What they do: Antitumor antibiotics prevent the DNA inside cancer cells from copying itself. Sometimes, they damage the cell’s DNA. Anthracyclines are a specific type of antitumor antibiotic.
Selected anthracyclines include:
- Daunorubicin.
- Doxorubicin.
- Doxorubicin liposomal.
- Epirubicin.
- Idarubicin.
- Mitoxantrone.
- Valrubicin.
Other antitumor antibiotics include:
- Bleomycin.
- Dactinomycin.
- Mitomycin-C.
Other chemotherapy drugs
Not all chemotherapy drugs fit into the main categories. Other common chemo drugs include:
- All-trans-retinoic acid.
- Arsenic trioxide.
- Asparaginase.
- Eribulin.
- Ixabepilone.
- Mitotane.
- Omacetaxine.
- Pegaspargase.
- Procarbazine.
- Romidepsin.
- Vorinostat.
Corticosteroids
What they do: Corticosteroids aren’t typically considered chemotherapy treatments. Healthcare providers prescribe them for a variety of conditions. Still, many people taking chemotherapy drugs also take corticosteroids to help manage side effects. These drugs can also kill cancer cells and prevent them from dividing.
Selected corticosteroids used during chemotherapy include:
- Dexamethasone.
- Hydrocortisone.
- Methylprednisolone.
- Prednisolone.
- Prednisone.
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What is the most common chemotherapy drug?
The most commonly prescribed chemotherapy medications are alkylating agents. They were also the first class of chemotherapy drugs developed. Still, other chemotherapy drugs or drug combinations may be more common depending on the type of cancer and how advanced it is (its stage).
