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ANTINEOPLASTIC AGENTS &
RECENT DRUGS USED IN
CANCER.
Presented by : Adhira Ambala
H.T No: 13TK1R0001
B.Pharmacy 4th year
Guided by: Mrs.Suhasini (Asst.proff.)
SVS School of pharmacy
Contents
1. Introduction.
2. What is cancer?
3. Types of cancer.
4. Causes and risk factors.
5. The classification of anticancer drugs.
6. Recently approved drugs.
7. References.
Introduction
• Cancer is not a single disease . It is a group of more
than 200 different diseases.
• Cancer may spread to other parts of the body.
• Currently 1 in 4 deaths in USA are due to cancer.
• 1 in 17 deaths are due to lung cancer.
• An estimated 2,22,520 people diagnosed lung
cancer in the united states in 2010.
INDIA.
• The four most common cancer in India are
• Male-oropharynx, esophagus, stomach and lower
respiratory tract
• Female-breast, cervix, oropharynx and esophagus
• Tobacco is widely used in India
• 91% cases of oropharynx is due to Tobacco use
• 60% cases in female are breast, cervix and ovary
cancer
WHAT IS CANCER?
• Antineoplastic agents are drugs used for the
treatment of cancer.
• Cancer or neoplasm ( Greek neo = new); plasm =
formation ) refers to a group of disease caused by
several agents viz.
• Chemical compounds, radiant energy .
• Cancer is characterised by an abnormal and
uncontroled division of cells exhibiting varying,
Degrees of malignancy which produce tumors and
invade adjacent normal tissue.
• Often cancer cells separate themselves from
primary tumor and carried by the lymphatic
system , reach distant sites of the organism ,
where they divide and form second
tumors(metastasis).
• The main characteristics of malignant are,
therefore, (a) autonomous growth , insentive to
the normal control mechanisms that limits cell
growth and division in differentiated tissues and
(b) invasiveness of adjacent capillaries and lymph
channel.
TYPES OF CANCER
Types of Cancer AFFECTED AREA
ANAL CANCER ANUS
BREAST CANCER BREAST
BLADDER CANCER URINARY BLADDER
BONE MARROW CANCER SHAFTS OF LONG BONES
COLON CANCER COLON
CERVICAL CANCER CERVIX
EYE CANCER EYE
GYNAEOCOLOGICAL CANCER FEMALE REPRODUCTIVE ORGANS
LUNG CANCER LUNGS
OSTEO SARCOMA METAPHYSEAL REGION OF LONG BONES
WILMS TUMOUR KIDNEY
LEUKEMIA BLOOD
LARYNX CANCER LARYNX
TESTICULAR CANCER TESTIS
RECTAL CANCER RECTUM
CAUSES AND RISK FACTORS
1.Environment
• cigarette smoke
 chemicals
 UV light
 viruses
2.Metabolic processes
• free radicals
 DNA copying and
repair defects
3.Inherited genetic mutations
The Classification of Anticancer Drugs
A. Drugs acting directly on cells (Cytotoxic
drugs)
1. Alkylating agents:
o These compounds produce highly reactive
carbonium ion intermediates which transfer
alkyl groups to cellular macro molecules by
forming covalent bonds.
o Alkylation results in cross linking/ abnormal
base pairing/scission of DNA strand.
Mechanism of action
Nitrogen mustard
Breast cancer,
Multiple
myeloma
head and neck carcinomas,
osteogenic sarcoma
Hodgkin’s disease,
T-cell lymphoma
Chronic lymphocytic
leukemia
Multiple myeloma,
Ovarian cancer, Breast
cancer
CYCLOPHOSPHAMIDE
SAR:
1. BIS-2-
CHLOROETHYLAMINO
GROUP IS ESSENTIAL.
2. CHLORO ATOM
PROVIDES MAXIMUM
ACTIVITY.
3. LEVO-ISOMER IS
INACTIVE.
USES:
1. Multiple myeloma, chronic lymphocytic
leukemia, Hodgkin's disease, ovarian and lung
cancer.
ADVERSE REACTIONS:
HAIR LOSS, STERILITY, TESTICULAR
ATROPHY, OVARIAN FIBROSIS,
SUPPRESSION OF MENSTRUATION.
Bestrabucil (phase I trial)
[Chlorambucil derivative]
Bendamustine
Recent drugs based on Nitrogen
mustard
Uramustine (Nitrogen mustard+Uracil
Derivative)
Ethylenimine
Alkyl sulfonate
Ovarian cancer, Breast cancer
Lymphoma
Chronic Myeloid
Leukemia
Nitrosoureas
Triazine
:- meningeal leukaemias and brain tumours(can cross
BBB)
Malignant melanoma;
Hodgkin's disease.
2. Antimetabolites
o These are analogues related to normal
components of DNA or of coenzymes involved in
nucleic acid synthesis.
o They competitively inhibit utilization of the
normal substrate or get themselves incorporated
forming dysfunctional macromolecules.
o Several of the useful drugs used in
antimetabolite therapy are purines, pyrimidines,
folates, and related compounds.
Folate antagonist:
Methotrexate
(NEOTREXATE)
MECHANISM OF ACTION:
•Methotrexate acts an antifolate by binding almost irreversibly to
the enzyme dihydrofolate reductase.
•Which prevents the formation of the coenzyme tetrahydrofolic
acid, essential for replication of animal cells.
USES:
Choriocarcinoma, trophoblast tumor and immunosuppressive agents.
Adverse effects:
Megaloblastic anemia, leukemia, diarrhoea, alopecia, intestinal tumour.
Purine antagonist
o These are highly effective antineoplastic drugs.
oThey are converted in the body to the
corresponding monoribonucleotides which inhibit
the conversion of inosine monophosphate to
adenine and guanine nucleotides.
N
N
N
H
N
SH
6-mercaptopurine
N
N
N
H
N
SH
H2N
Thioguanine
USE: Childhood acute leukemia
USE: Adult acute leukemia
• Recent drugs based on purines and related
compounds:
N
N
N
N
NH2
Cl
O
HO
HO
Cladribine
N
N
N
N
NH2
O
HO
HO
Vidarabine
OH
N
N
N
N
NH2
O
HO
HO
Clofarabine
F
Cl
N
N
O
HO
HO
Pentostatin
HN
N
OH
N
N
N
N
NH2
O
HO
O
OH
PHO
O
OH F
Fludarabine
Pyrimidine antagonist
o Pyrimidine analogues have varied applications
as antineoplastic, antifungal and antipsoriatic
agents.
HN
N
H
O
O
F
5-Fluorouracil
5-Fluorouracil is converted in the
body to the corresponding
nucleotide 5-fluoro-2-deoxyuridine
monophosphate, which inhibits
thymidylate synthase and blocks the
conversion of deoxyuridilic acid to
deoxythymidylic acid.
This leads to elective failure of DNA
synthesis.
Adenocarcinoma,
Skin cancer
Mechanismof action:
Recent drugs
3. Natural anticancer agents:
Vinca alkaloids
o These are mitotic inhibitors, bind to
microtubular protein-'tubulin', prevent its
polymerization and assembly of microtubules,
cause disruption of mitotic spindle and interfere
with cytoskeletal function.
o The chromosomes fail to move apart during
mitosis: metaphase arrest occurs.
o They are cell cycle specific and act in the
mitotic phase.
Hodgkin’s disease,
Acute lymphocytic
leukemia,
Lung cancer
VINCRISTINE
MECHANISM OF ACTION: USES:
•Acute leukemia,
•lymphomas, wilm’s
tumour, choriocarcinoma.
ADVERSE REACTION:
•Neurotoxicity, areflexia,
paralytic ileus.
Taxanes
o First isolated from bark of
Western / Pacific yew (Taxus
brevifolia)
Uses: It is used for treatment
of lung, ovarian and breast
cancer.
Mechanism of action: Taxanes hyper-stabilizes
microtubule structure (freez them). Taxanes binds to
the β subunit of tubulin ,the resulting microtubule/
Taxanes complex does not have the ability to
disassemble. This adversely affects cell function
because the shortening and lengthening of
microtubules is necessary for their function.
Semi-synthetic derivatives
Ovarian cancer, Breast cancer,
Non –small cell lung cancer
Epipodophyllotoxin
From Podophyllum peltarum
May apple
O
O
O
OMe
OMeMeO
OH
O
Podophyllotoxin
O
O
O
OH
OMeMeO
O
Etoposide
O
OO
HO
HO
MOA: Affects DNA
topoisomerase II
(not intercalating)
DNA strand
breakage
Uses:Small cell lung cancer, Non-Hodgkin’s
lymphomas,
Kaposi’s sarcoma, Cervical cancer
Camptothecin analogues
o First isolated Camptotheca acuminata
(Chinese tree).
o Inhibits DNA topoisomerase II DNA
strand breakage
N
N
O
O
OOH
Camptothecin,
toxic, Lead comp.
N
N
O
O
OOH
HO
N
N
N
O
O
OOH
O
N O
N
Topotecan
Hycamtin®
Irinotecan
Campto®
Semisynthetic
USES: Ovarian cancer, Small cell lung cancer
4. Antibiotics
o These are products obtained from
microorganisms and have prominent antitumour
activity.
o Practically all of them intercalate between DNA
strands and interfere with its template function.
Actinomycin D
Wilms' tumour,
Rhabdomyosarcoma
Adverse reaction:
-bone marrow suppression
-sensitizes to radiation, and inflammation at
the sites of prior radiation therapy may occur.
-gastrointestinal adverse effects.
Examples:
Doxorubicin
Mitoxantrone
Kaposi’s sarcoma,
Small cell lung cancer,
Breast cancer,
Malignant lymphomas
Prostate cancer,
Multiple sclerosis
Mitomycin
Daunorubicin
Kaposi’s sarcoma,
Acute myeloid leukemia
Carcinomas of the cervix,
Breast, lung, stomach
Recent anticancer antibiotics drugs:
Calicheamicin
(Preclinical )
o 5. Miscellaneous :
o These drugs have been developed by
random synthesis and testing for anti tumour
activity.
Procarbazine
Hydroxyurea
Hodgkin's disease,
Non-Hodgkin lymphomas,
Oat cell carcinoma of lung
Chronic myeloid leukaemia,
Psoriasis, Polycythaemia
Cisplatin
Carboplatin
Imatinib
Metastatic testicular
and
Ovarian carcinoma
Squamous carcinoma of
head
and neck,
Small cell lung cancer,
Seminoma
chronic myeloid
leukaemia
Recent drugs
Gefitinib
Erlotinib
Crizotinib
Non-Small
Cell lung
cancer
(PROTEIN
KINASE
INHIBITORS)
Oxaliplatin
Ovarian carcinoma,
Seminoma
B. Drugs acting on Hormones
o It involves the manipulation of the endocrine
system through exogenous administration of
specific hormones, particularly steroid hormones,
or drugs which inhibit the production or activity of
such hormones.
o Because steroid hormones are powerful drivers
of gene expression in certain cancer cells,
changing the levels or activity of certain hormones
can cause certain cancers to cease growing, or
even undergo cell death.
1. Corticosteroids :
o Corticosteroids are strong anti-inflammatory
drugs.
Examples
Prednisolone
palliation of lymphomas
and leukemias
2. Estrogens
o The agonist is occasionally used to treat
prostate cancer through suppression of
testosterone production.
Fosfestrol
carcinoma
prostate
Ethinylestradiol
3. ESTROGEN INHIBITORS
TamoxifenToremifene
o Acts by selective antagonism of the estrogen
receptor.
Breast
cancer
4.Aromatase inhibitors
• Aromatase is the enzyme that synthesizes estrogen.
• Aromatase inhibitors (AIs) are a class of drugs used in
the treatment of breast cancer and ovarian cancer in
postmenopausal women.
Breast cancer
Letrozole
5. Antiandrogen
•prevent androgens from expressing their biological
effects on responsive tissues.
•Antiandrogens alter the androgen pathway by blocking
the appropriate receptors, competing for binding sites on
the cell's surface, or affecting androgen production.
USES: Antiandrogens are most frequently used to treat
prostate cancer.
Flutamide
Nilutamide
Recently Approved Drugs by FDA
DRUGS USES
2016
ofatumumab Chronic lymphocytic
leukemuia
eribulin Unsectable or metastatic
liposarcoma
olaratumab Soft tissue sarcoma
crizotinib Non- small cell lung cancer
defitelio Adult and pediatric with
hepatic venoocculsive
disease(VOD)
cabozantinib Renal cell carcinoma
DRUGS USES
2015
Palbociclib postmenopausal, advanced
breast cancer
levnatunib Thyroid cancer
panobinostat Multiple myeloma
nivolumab Non-small cell lung cancer
dinutuximab Pediatric patients with high risk
neuroblastoma
ramucirumab Metastatic colorectal cancer
irinotecan Metastatic adrenocarcinoma
Drugs Uses
2014
Belinostat Peripheral T-cell lymphoma
Ramucirumab Gastric cancer
Ibrutinib Chronic lymphocytic leukemia
Idelalisib Relapsed Chronic lymphocytic leukemia
Ceritinib Non-small cell lung Cancer
lanreotide Metastatic gastroenteropancreatic tumours
Drugs Uses
2013
Obinutuzumab Chronic lymphocytic leukemia
Afatinib Metastatic non-small cell lung cancer
Ibrutinib Mantle cell lymphoma
Trametinib Metastatic melanoma
Pomalidomide Relapsed and refractory multiple myeloma
Lenalidomide Mantle cell lymphoma
Regorafenib Gastrointestinal stromal tumor
Dabrafenib Metastatic melanoma
Denosumab Prostate cancer
References
2. Essentials of Medical Pharmacology, Sixth Edition, K.D TRIPATHI
1. Wilson and Gisvold's textbook of organic medicinal and
pharmaceutical chemistry, Twelfth Edition, Charles Owens
wilson, Ole Gisvold
3. Foye’s Principles of medicinal chemistry, Sixth Edition,
http://www.fda.gov/drugs/informationondrugs/approveddrug
s/ ucm279174.htm
4.
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anticancer agents

  • 1. ANTINEOPLASTIC AGENTS & RECENT DRUGS USED IN CANCER. Presented by : Adhira Ambala H.T No: 13TK1R0001 B.Pharmacy 4th year Guided by: Mrs.Suhasini (Asst.proff.) SVS School of pharmacy
  • 2. Contents 1. Introduction. 2. What is cancer? 3. Types of cancer. 4. Causes and risk factors. 5. The classification of anticancer drugs. 6. Recently approved drugs. 7. References.
  • 3. Introduction • Cancer is not a single disease . It is a group of more than 200 different diseases. • Cancer may spread to other parts of the body. • Currently 1 in 4 deaths in USA are due to cancer. • 1 in 17 deaths are due to lung cancer. • An estimated 2,22,520 people diagnosed lung cancer in the united states in 2010.
  • 4. INDIA. • The four most common cancer in India are • Male-oropharynx, esophagus, stomach and lower respiratory tract • Female-breast, cervix, oropharynx and esophagus • Tobacco is widely used in India • 91% cases of oropharynx is due to Tobacco use • 60% cases in female are breast, cervix and ovary cancer
  • 5. WHAT IS CANCER? • Antineoplastic agents are drugs used for the treatment of cancer. • Cancer or neoplasm ( Greek neo = new); plasm = formation ) refers to a group of disease caused by several agents viz. • Chemical compounds, radiant energy . • Cancer is characterised by an abnormal and uncontroled division of cells exhibiting varying, Degrees of malignancy which produce tumors and invade adjacent normal tissue.
  • 6. • Often cancer cells separate themselves from primary tumor and carried by the lymphatic system , reach distant sites of the organism , where they divide and form second tumors(metastasis). • The main characteristics of malignant are, therefore, (a) autonomous growth , insentive to the normal control mechanisms that limits cell growth and division in differentiated tissues and (b) invasiveness of adjacent capillaries and lymph channel.
  • 7. TYPES OF CANCER Types of Cancer AFFECTED AREA ANAL CANCER ANUS BREAST CANCER BREAST BLADDER CANCER URINARY BLADDER BONE MARROW CANCER SHAFTS OF LONG BONES COLON CANCER COLON CERVICAL CANCER CERVIX EYE CANCER EYE GYNAEOCOLOGICAL CANCER FEMALE REPRODUCTIVE ORGANS LUNG CANCER LUNGS OSTEO SARCOMA METAPHYSEAL REGION OF LONG BONES WILMS TUMOUR KIDNEY LEUKEMIA BLOOD LARYNX CANCER LARYNX TESTICULAR CANCER TESTIS RECTAL CANCER RECTUM
  • 8. CAUSES AND RISK FACTORS 1.Environment • cigarette smoke  chemicals  UV light  viruses 2.Metabolic processes • free radicals  DNA copying and repair defects 3.Inherited genetic mutations
  • 9.
  • 10. The Classification of Anticancer Drugs A. Drugs acting directly on cells (Cytotoxic drugs) 1. Alkylating agents: o These compounds produce highly reactive carbonium ion intermediates which transfer alkyl groups to cellular macro molecules by forming covalent bonds. o Alkylation results in cross linking/ abnormal base pairing/scission of DNA strand.
  • 12. Nitrogen mustard Breast cancer, Multiple myeloma head and neck carcinomas, osteogenic sarcoma Hodgkin’s disease, T-cell lymphoma Chronic lymphocytic leukemia Multiple myeloma, Ovarian cancer, Breast cancer
  • 13. CYCLOPHOSPHAMIDE SAR: 1. BIS-2- CHLOROETHYLAMINO GROUP IS ESSENTIAL. 2. CHLORO ATOM PROVIDES MAXIMUM ACTIVITY. 3. LEVO-ISOMER IS INACTIVE. USES: 1. Multiple myeloma, chronic lymphocytic leukemia, Hodgkin's disease, ovarian and lung cancer. ADVERSE REACTIONS: HAIR LOSS, STERILITY, TESTICULAR ATROPHY, OVARIAN FIBROSIS, SUPPRESSION OF MENSTRUATION.
  • 14. Bestrabucil (phase I trial) [Chlorambucil derivative] Bendamustine Recent drugs based on Nitrogen mustard Uramustine (Nitrogen mustard+Uracil Derivative)
  • 15. Ethylenimine Alkyl sulfonate Ovarian cancer, Breast cancer Lymphoma Chronic Myeloid Leukemia
  • 16. Nitrosoureas Triazine :- meningeal leukaemias and brain tumours(can cross BBB) Malignant melanoma; Hodgkin's disease.
  • 17. 2. Antimetabolites o These are analogues related to normal components of DNA or of coenzymes involved in nucleic acid synthesis. o They competitively inhibit utilization of the normal substrate or get themselves incorporated forming dysfunctional macromolecules. o Several of the useful drugs used in antimetabolite therapy are purines, pyrimidines, folates, and related compounds.
  • 18. Folate antagonist: Methotrexate (NEOTREXATE) MECHANISM OF ACTION: •Methotrexate acts an antifolate by binding almost irreversibly to the enzyme dihydrofolate reductase. •Which prevents the formation of the coenzyme tetrahydrofolic acid, essential for replication of animal cells. USES: Choriocarcinoma, trophoblast tumor and immunosuppressive agents. Adverse effects: Megaloblastic anemia, leukemia, diarrhoea, alopecia, intestinal tumour.
  • 19. Purine antagonist o These are highly effective antineoplastic drugs. oThey are converted in the body to the corresponding monoribonucleotides which inhibit the conversion of inosine monophosphate to adenine and guanine nucleotides. N N N H N SH 6-mercaptopurine N N N H N SH H2N Thioguanine USE: Childhood acute leukemia USE: Adult acute leukemia
  • 20. • Recent drugs based on purines and related compounds: N N N N NH2 Cl O HO HO Cladribine N N N N NH2 O HO HO Vidarabine OH N N N N NH2 O HO HO Clofarabine F Cl N N O HO HO Pentostatin HN N OH N N N N NH2 O HO O OH PHO O OH F Fludarabine
  • 21. Pyrimidine antagonist o Pyrimidine analogues have varied applications as antineoplastic, antifungal and antipsoriatic agents. HN N H O O F 5-Fluorouracil 5-Fluorouracil is converted in the body to the corresponding nucleotide 5-fluoro-2-deoxyuridine monophosphate, which inhibits thymidylate synthase and blocks the conversion of deoxyuridilic acid to deoxythymidylic acid. This leads to elective failure of DNA synthesis. Adenocarcinoma, Skin cancer Mechanismof action:
  • 23. 3. Natural anticancer agents: Vinca alkaloids o These are mitotic inhibitors, bind to microtubular protein-'tubulin', prevent its polymerization and assembly of microtubules, cause disruption of mitotic spindle and interfere with cytoskeletal function. o The chromosomes fail to move apart during mitosis: metaphase arrest occurs. o They are cell cycle specific and act in the mitotic phase.
  • 25. VINCRISTINE MECHANISM OF ACTION: USES: •Acute leukemia, •lymphomas, wilm’s tumour, choriocarcinoma. ADVERSE REACTION: •Neurotoxicity, areflexia, paralytic ileus.
  • 26. Taxanes o First isolated from bark of Western / Pacific yew (Taxus brevifolia) Uses: It is used for treatment of lung, ovarian and breast cancer. Mechanism of action: Taxanes hyper-stabilizes microtubule structure (freez them). Taxanes binds to the β subunit of tubulin ,the resulting microtubule/ Taxanes complex does not have the ability to disassemble. This adversely affects cell function because the shortening and lengthening of microtubules is necessary for their function.
  • 27. Semi-synthetic derivatives Ovarian cancer, Breast cancer, Non –small cell lung cancer
  • 28. Epipodophyllotoxin From Podophyllum peltarum May apple O O O OMe OMeMeO OH O Podophyllotoxin O O O OH OMeMeO O Etoposide O OO HO HO MOA: Affects DNA topoisomerase II (not intercalating) DNA strand breakage Uses:Small cell lung cancer, Non-Hodgkin’s lymphomas, Kaposi’s sarcoma, Cervical cancer
  • 29. Camptothecin analogues o First isolated Camptotheca acuminata (Chinese tree). o Inhibits DNA topoisomerase II DNA strand breakage N N O O OOH Camptothecin, toxic, Lead comp. N N O O OOH HO N N N O O OOH O N O N Topotecan Hycamtin® Irinotecan Campto® Semisynthetic USES: Ovarian cancer, Small cell lung cancer
  • 30. 4. Antibiotics o These are products obtained from microorganisms and have prominent antitumour activity. o Practically all of them intercalate between DNA strands and interfere with its template function.
  • 31. Actinomycin D Wilms' tumour, Rhabdomyosarcoma Adverse reaction: -bone marrow suppression -sensitizes to radiation, and inflammation at the sites of prior radiation therapy may occur. -gastrointestinal adverse effects. Examples:
  • 32. Doxorubicin Mitoxantrone Kaposi’s sarcoma, Small cell lung cancer, Breast cancer, Malignant lymphomas Prostate cancer, Multiple sclerosis
  • 33. Mitomycin Daunorubicin Kaposi’s sarcoma, Acute myeloid leukemia Carcinomas of the cervix, Breast, lung, stomach
  • 34. Recent anticancer antibiotics drugs: Calicheamicin (Preclinical )
  • 35. o 5. Miscellaneous : o These drugs have been developed by random synthesis and testing for anti tumour activity. Procarbazine Hydroxyurea Hodgkin's disease, Non-Hodgkin lymphomas, Oat cell carcinoma of lung Chronic myeloid leukaemia, Psoriasis, Polycythaemia
  • 36. Cisplatin Carboplatin Imatinib Metastatic testicular and Ovarian carcinoma Squamous carcinoma of head and neck, Small cell lung cancer, Seminoma chronic myeloid leukaemia
  • 38. B. Drugs acting on Hormones o It involves the manipulation of the endocrine system through exogenous administration of specific hormones, particularly steroid hormones, or drugs which inhibit the production or activity of such hormones. o Because steroid hormones are powerful drivers of gene expression in certain cancer cells, changing the levels or activity of certain hormones can cause certain cancers to cease growing, or even undergo cell death.
  • 39. 1. Corticosteroids : o Corticosteroids are strong anti-inflammatory drugs. Examples Prednisolone palliation of lymphomas and leukemias
  • 40. 2. Estrogens o The agonist is occasionally used to treat prostate cancer through suppression of testosterone production. Fosfestrol carcinoma prostate Ethinylestradiol
  • 41. 3. ESTROGEN INHIBITORS TamoxifenToremifene o Acts by selective antagonism of the estrogen receptor. Breast cancer
  • 42. 4.Aromatase inhibitors • Aromatase is the enzyme that synthesizes estrogen. • Aromatase inhibitors (AIs) are a class of drugs used in the treatment of breast cancer and ovarian cancer in postmenopausal women. Breast cancer Letrozole
  • 43. 5. Antiandrogen •prevent androgens from expressing their biological effects on responsive tissues. •Antiandrogens alter the androgen pathway by blocking the appropriate receptors, competing for binding sites on the cell's surface, or affecting androgen production. USES: Antiandrogens are most frequently used to treat prostate cancer. Flutamide Nilutamide
  • 44. Recently Approved Drugs by FDA DRUGS USES 2016 ofatumumab Chronic lymphocytic leukemuia eribulin Unsectable or metastatic liposarcoma olaratumab Soft tissue sarcoma crizotinib Non- small cell lung cancer defitelio Adult and pediatric with hepatic venoocculsive disease(VOD) cabozantinib Renal cell carcinoma
  • 45. DRUGS USES 2015 Palbociclib postmenopausal, advanced breast cancer levnatunib Thyroid cancer panobinostat Multiple myeloma nivolumab Non-small cell lung cancer dinutuximab Pediatric patients with high risk neuroblastoma ramucirumab Metastatic colorectal cancer irinotecan Metastatic adrenocarcinoma
  • 46. Drugs Uses 2014 Belinostat Peripheral T-cell lymphoma Ramucirumab Gastric cancer Ibrutinib Chronic lymphocytic leukemia Idelalisib Relapsed Chronic lymphocytic leukemia Ceritinib Non-small cell lung Cancer lanreotide Metastatic gastroenteropancreatic tumours
  • 47. Drugs Uses 2013 Obinutuzumab Chronic lymphocytic leukemia Afatinib Metastatic non-small cell lung cancer Ibrutinib Mantle cell lymphoma Trametinib Metastatic melanoma Pomalidomide Relapsed and refractory multiple myeloma Lenalidomide Mantle cell lymphoma Regorafenib Gastrointestinal stromal tumor Dabrafenib Metastatic melanoma Denosumab Prostate cancer
  • 48. References 2. Essentials of Medical Pharmacology, Sixth Edition, K.D TRIPATHI 1. Wilson and Gisvold's textbook of organic medicinal and pharmaceutical chemistry, Twelfth Edition, Charles Owens wilson, Ole Gisvold 3. Foye’s Principles of medicinal chemistry, Sixth Edition, http://www.fda.gov/drugs/informationondrugs/approveddrug s/ ucm279174.htm 4.