This document summarizes different classes of antineoplastic (anticancer) drugs, including their mechanisms of action, cell cycle specificity, and common side effects. The classes discussed include alkylating agents, nitrosoureas, topoisomerase inhibitors, antimetabolites, antitumor antibiotics, mitotic spindle poisons, hormonal agents, and miscellaneous agents. For each class, specific drug examples are provided along with a brief description of their mechanism of action and the typical phases of the cell cycle they act on. Common side effects are also listed for each class.

1. ANTINEOPLASTIC
Drug Class and Examples Mechanism of Action Cell Cycle Specificity Common Side Effects
Alkylting Agents
Busulfan (Busulfex.Myleran), carboplatin Alter DNA structure by Cell cycle-nonspecific Bone marrow
(Paraplatin), chlorambucil (Leukeran) misreading DNA code, suppression, nausea,
,cisplatin (Platinol,AQ), cylophos- phamide intiating breaks in the vomiting, cystitis
(Cytoxan),dacarbazine (DTIC, DNA molecule,cross- (cyclophosphamide;
Dome),hexamethylene amine or linkin DNA strands ifosfamide), stomatitics,
altertamine (Hexalen) alopecia, gonabal
,ifosfamide(Ifex),melphalan (Alkeran), suppression, renal
nitrogen mustard (Mustargen), toxicity (cisplatin)
oxaliplation(Eloxatin), thiotepa (Thioplex)
Nitrosoureas Similar to the alkylating Cell cycle-nonspecific Delayed and cumulative
Carmustine(BCNU[BiCNU,Gliadel]), agents; cross the blood- myelosuppression,
lomustine or CCNU (CeeNU), semustine brain barrier especially
(methyl CCNU[ MeCCNU]),streptozocin thrombocytopenia;nausea
(Zanosar) vomiting
Topoisomerase I Inhibitors Irinotecan Induce breaks in the Cell cycle-specific (S phase) Bone marrow
(Camprosar) Topotecan (Hycamtin) DNA strand by binding suppression, diarrhea,
to enzyme nausea,vomiting ,
topoisomerase I, hepatotoxicity
preventing cells from
dividing
Antimetabolites
5-Azacytadine, capecitabine (Xeloda), Interferes with the Cell Cycle–specific (Sparse) Nausea, vomiting,
cytarabine (DepoCyt, Tarabine),edatrexate biosynthesis of diarrhea, bone marrow
fludarabine (flurada), 5-fluorouracil (5- metabolites or nucleic suppression, proctitics,
FU),gemcitabine (Gemzar), hydroxyurea acids necessary for RNA stomatitis, renal toxicity
(Droxia, Hydrea),cladribine (Leustatin), 6- and DNA synthesis (methotrexate),
mercaptopurine (Purinethol), mercaptopurine hepatotoxicity
(Trexall, Rheumarrex), pentostatin (Nipent),
6-thioguanine (Tabloid)
Antitumor Antibiotics Interfere with DNA Cell cycle-nonspecific Bone marrow
Bleomycin (BLM, Blenoxane), dactinomycin synthesis by biding suppression nausea,
(Cosmegen), daunorubicin(DaunoXome), DNA; prevent RNA vomiting alopecia,
doxorubicin (Adriamycin), synthesis anorexia, cardiac toxicity
idarubicin(Idamycin), mitomycin (daumorubicin,
(Mutamycin), mitoxantrone (Novantrone), doxorubicin)
plicamyin (Mithracin)
Bone marrow
Mitotic Spindle Poisons Arrest metaphase by Cell cycle-specific (M phase) suppression (mild with
Plant Alkaloids: etoposide (Toposar), inhibiting mitotic tubular VCR), neuropathies
teniposide (Vumon)vinblastine (Velban), formation (spindle); (VCR), stomatitis
vincristine (VCR[Oncovin]), vindesine inhibit DNA and protein
(Eldisine),vinorelbine (Navelbine) synthesis Bradcardia,
Taxanes: paclitaxel (Taxol), docetaxel Arrest metaphase by Cell cycle-specific (M phase) hypersensitivity
(Taxotere) inhibiting tubulin reactions, bone marrow
depolymerization suppression, alopecia
neuropathics
Hormonal Agents Bind to hormone Cell cycle-nonspecific Hypercalcemia, jaundice,
Androgens and antiandrogens, estrogens and receptors sites that alter increased appetite,
antiestrogens, progestins and antiprogestin, cellular growth; block masculinization,
aromatase inhibitors, luteinizing hormone- binding of estrogens to feminization, sodium and
releasing hormone analogues, steroids receptors sites fluid rerention, nausea,
(antiestrogen); inhibit vomiting hot
RNA synthesis; suppress flashes,vaginal estrogen
aromarase of P450 dryness
system, which decreases
level
Miscellaneous Agents Unknown or too Varies Anorexia, nausea
Asparaginase (Elspar), procarbazine complex to categorize vomiting bone marrow
(Matulane) suppression
hepatotoxicity,
anaphylaxis,
hypotension, altered
glucose metabolism