Anti-Cancer Drugs

1. Traditional Chemotherapy

Alkylating Agents / Cyclophosphamide (Cytoxan), Chlorambucil, Temozolomide (Temidar)

Antibiotics / Doxorubicin (Adriamycin -Red Devil), Epirubicin (Ellence), Bleomycin, Chloramphenicol, Mitomycin

Platinum Complexes / Cisplatin, Carboplatin, Oxaliplatin 

Antimetabolites / antifolate - Methotrexate, Purine analogues Mercaptopurine, Thioguanine, Pyrimidine analogues / 5-Flourouracil, Capecitabine, Gemcitabine

Nucleoside analogue / gemcitabine (Gemzar)

Folfox / Oxaliplatin, 5FU, Leucovrin - use of Curcumin together 

Folfiri / Ironotecan, 5FU, Leucoviron (folinic acid)

Vinca Alkaloids /Vincristine, Vinblastine

Taxanes  Microtubule Cytoskeleton / Pacltaxel (Taxol) Taxatere (Synthet)

Angiogenesis blockers / Bevacizimab (Avastatin), Pazopamib, Gefitinib, Erlotinib – the repurposed drug anti-hypertensive as  Losartan effect 

2. Hormone Antagonists
Anti-estrogen / Aromatase Inhibitors Anastrozole (Arimidex), Letrozole (Femara), Exemestane (Aromasin), Fulvestrant (Fasolodex), 

Hormone Competitor for Receptors / Tamoxifen

 Pituitary Central Approach -Luteinizing Hormone Releasing Hormone (LHRH) analogues- Leuprolide (Lupron) stop ovarian and testicular function for breast and prostate cancer   usually 1month, 3months, 6 months and 1 year duration

Hormone Antagonists Anti Testosterone / Bicalutamide (Casodex 25 mg), Flutamide, Nilutamide, Cyproterone

BRCA gene mutations PARP protein repair DNA mutations – only 5% of all breast cancers /

 Olaparib, Talaxoparib

Targeted for triple negative breast cancer ER-, PR-, Hers- 

3. Metabolic Molecules
  Dichloroacetate + thiamine / Deoxy glucose / Palladium Lipoid Acid

3 Bromopyruvate / Oxaloacetate / Niacin Vitamin B3, Niacinamide, Niacin mononucleotide (NMN)/ Rapamycin

4. Repurposed Drugs
Were Studied Against Cancer by Accident as Metformin from the Women’s Health Initiative by Dr. Pamela Goodwin of U. of Toronto. In UK, Europe, India, Taiwan now USA. Other Drugs Such As NSAID anti-inflammatory Were Known to synergistic with traditional Chemotherapy Drugs

One of the respectable oncologist named Michael P. Lasanti MD PhD just moved from the United States just moved to United Kingdom University of Salford Manchester to focus on cancer micro environment intervention and will be studying many drugs available to bring many old drugs as repurposed drugs to be used in the near future.

Repurposed Drugs Metformin now as a cream to avoid gastrointestinal symptoms and higher doses / Doxycycline/ Flaygl / Chloroquine and / clioquinol Hydrochloroquine / Ivermectin / Prosac /Digoxin / Lipitor and other statins / Persantine, Feldene, Aspirin / Mebendazole and Fenbendazole / Propanolol / Losartin /Coltran/ Accutane and Isoretinoin  / Tamoxifen / Isotretinion / Lipitor 10mg / / minocin /Salinomycin (drug from bacteria Streptomyces Albu  iron sequestration into lysosomes intracellularly)

Lipid Blocking Agents 

FASN Inhibitors Fatty Acid Synthase Inhibitors Causing Cytotoxicity of Cancer cells

Fatty acid Omega 3,6,9, all play a role in effecting cell membrane function and structure GLA Primrose Oil 1000 mg / Orlistat =Xenical 120 mg  or Alli 60mg 2x = 120mg weight loss medicine day / Triclosan / Thiolactomycin / Taxoprexin (DHA covalent bonded to Paclitaxel- analogue of DHA)

5. Cell and Organelle Membrane Stabilization and Restructure and Differentiation and Redifferentiation, Apoptosis+ cell death, and Differentiation of cancer stem cells  

Phosphatidyl Choline ( Body Bio & Quick Brands) / Sodium Butyrate  / Tributyrates= Tributyrin called are a form of glycerol butyrates/ Lauricidin brand of caprylic acid carbon 8 and Lauric fatty acid carbon 12 glycerol membrane effecting infectious cell membrane as well as all cell membranes. Phenylbutyrates  work together with Phosphatidyl Choline in cell differentiation process and also blocks glutamine amino acids. 

6. Senolytic compounds
are natural compounds flavones and drugs that destroy aging defective cells and functionless but can secret SASP molecules which can trigger carcinomatosis

Quercetin 2000 mg day/ Fisetin another natural product / Tocotrienols Vitamin Gamma 4 groups)125 to 400 mgday by Annato company  / Rutin / Luteolin / Dasatinib drug  Bristol Myers 20mg doses / Navtochlox (ABT 263)/ Piperlangumine natural product

7. Natural Molecules Against Cancer 

Broccoli Sprouts / Curcumin / Luteolin / Quercetin / Fisetin /  Fermented Wheat Germ- Metatrol Pro better than Avemar / Cholera Vaccine / Mushrooms (chaga / shitake / turkey tail) /Shark Liver Oil / Melatonin hormone as Natural Killer Cell enhancers

8. Monoclonal Antibody
/ Trastuzumab  and biosimilars  (Hersceptin, Ogivri, Herzuma,Ontrugant, Trazimera, Kanjinti / Pembrolizumab (Keytruda), , Novolumub (Optiva), Dostarlimab -latest success story on metastatic rectal cancer

Monoclonal Antibody-Drug Conjugate-bonded to Chemo Drug Conjugate 

Fam-Trastuzumab-Deruxtecan (Enhertu) drug is similar to Irinotecan (iv) -lung problems / Sacituzumab-Govitecan (Trodelvy)

9. Targeted Inhibitors Tailor Made Therapy

Brief History to Understand These Short-Lived Approach lasting 6-8 months and then cancer resistance

After TCGA cancer genome atlas and now the use of liquid biopsy using blood samples to study fragmented DNA and also PD 1 proteins , we discovered mutations and to target the end product protein or peptide with an antibody . The first BRAF inhibitor (Vemurafenib)  for Melanoma. Then came the Tyrosine Kinase Inhibitors and one of the first was Crizotinib inhibitor which had the longest duration of effect of about 8 months and before cancer resistance. 

10. T Cell Intrinsic Inhibitors
1990s of which the CTLA-4 (Ipilimumab) the first of the “Checkpoint Inhibitors”. The duration of effect was longer and it could cover a broad number of cancers regardless of cancer heterogeneity or differences. Next came PD1 (Programed Cell Death 1) and PDL-1 in 2002 which is an antibody to PD1   Pemlroluzimab (Keytruda which was used to treat former President Carter for Melanoma) and after Nivolumab as the second which was combined with Docetaxel a chemotherapeutic drug with better duration of results. Most of these drugs had a common liver or hepatoxicity and we started using steroid as Dexamethasone to decrease the toxicity

11. Tyrosine Kinase Inhibitors
/ kinase protein make cell grow and therefore inhibitors / EFGF TKI  inhibitors / Imatinib (Gleevac), Sorafernib ,  Dasatinib, Carbozantinib (Cabometyx), Lapatinib (Tykerb) , Sunitinib, Pazophnib, Vemurafenib (first BRAF inhibitor ), Dabrafenib, Neratinib (Nerlynx), Tucatinib (Tukysa) Bosoinib, Saracetinib, Soretenib -all had toxicity of  hand-foot syndromes and liver problems 

12. CDK4/6 Inhibitors – Cyclin dependant kinases /Palbociclib (Ibrance) Ribociclib (Kisqali) , Abemaciclib (Verzenio often with Aromatase inhibitor or hormone antagonist)

13. MTOR inhibitors
  block cell growth and angiogenesis - Rapamycin never used an now a longevity drug,   Everolimus (Afinitor) – oral routeOral complications- mouth sores, rash, blood lipids up

14. KRASE cell Inhibitors
/ Japatinib (Tykerb ),  Neratonib (Nerlynx), Tocatinib (Turkgsa) – hand foot syndrome ( KRAS mutation is especially high in pancreatic cancer

15. TAM TRegCD4
/ Magamizumab, Pexidatynib, Ehactizimab

16. PI3K Inhibitors – mutated PIK3CA gene mutation
, oral po / Alpelisib (Piqray)

17. CD47 protein
monoclonal antibody to block CD47

CD20 Rituximab

CD22 Epratuzumab

CD52 Alemtuzumab

KRAS inhibitor Soporose (Lumakras) oral route

Target EMT Steriod TKI /Dasatinib, Bosoinib, Saracetinib, Soretenib 

Immune CP Inhibitors / Pembrolizumab (Keytruda), Atelzlizumab

Mitochondrial Injury by Heat Shock Protein HSP90 

Geldanamycin and brand name Gamitrinibs on NCI study

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