The antineoplastic or anticancer medicines have vast diversity. In general these medications have limited use but play significant role in clinical applications. Hepatotoxicity is a most common side effect of antineoplastic drugs.
The classification of antineoplastic drugs is complex. Antineoplastic drugs can be classified based on
Indication (lymphoma, leukemia, melanoma, solid tumor)
Mechanism of action (such as alkylating agents, antibiotics, biological response modifiers, antiandrogens, topoisomerase inhibitors or protein kinase inhibitors)
Chemical structure (folic acid analog, platinum coordination complex, purine or pyrimidine analog, monoclonal antibody)
Cytotoxic or nonspecific vs noncytotoxic or targeted.
However, conventionally antineoplastic drugs are classified under five categories – alkylating agents, antimetabolites, natural products, hormones and antagonists, and miscellaneous. Currently, the miscellaneous group of antineoplastic drugs contains some most important agents. The discovery of antineoplastic drugs is ongoing process. Every year 5 and 10 new anticancer agents are approved and enlisted under miscellaneous group. Some of the recently invented antineoplastic drugs have not been well defined hepatotoxic effect. The following classifications of antineoplastic drugs not contain the medications which are in pipeline.
Classification of antineoplastic drugs
Alkylating Agents
Altretamine, Bendamustine, Busulfan, Carmustine, Chlorambucil, Cyclophosphamide, Dacarbazine, Ifosfamide, Lomustine, Mechlorethamine, Melphalan, Procarbazine, Streptozocin, Temozolomide, Thiotepa, Trabectedin
Platinum Coordination Complexes
Carboplatin, Cisplatin, Oxaliplatin
Antibiotics, Cytotoxic
Bleomycin, Dactinomycin, Daunorubicin, Doxorubicin, Epirubicin, Idarubicin, Mitomycin, Mitoxantrone, Plicamycin, Valrubicin
Antimetabolites
Antifolates: Methotrexate, Pemetrexed, Pralatrexate, Trimetrexate
PurineAnalogues: Azathioprine, Cladribine, Fludarabine, Mercaptopurine, Thioguanine
PyrimidineAnalogues: Azacitidine, Capecitabine, Cytarabine, Decitabine, Floxuridine, Fluorouracil, Gemcitabine, Trifluridine/Tipracil
Biologic Response Modifiers
Aldesleukin (IL-2), Denileukin Diftitox, Interferon Gamma
Histone Deacetylase Inhibitors
Belinostat, Panobinostat, Romidepsin, Vorinostat
Hormonal Agents
Antiandrogens: Abiraterone, Apalutamide, Bicalutamide, Cyproterone, Enzalutamide, Flutamide, Nilutamide
Antiestrogens (including Aromatase Inhibitors): Anastrozole, Exemestane, Fulvestrant, Letrozole, Raloxifene, Tamoxifen, Toremifene
Gonadotropin Releasing Hormone Analogues: Degarelix, Goserelin, Histrelin, Leuprolide, Triptorelin
Peptide Hormones: Lanreotide, Octreotide, Pasireotide
Monoclonal Antibodies
Alemtuzumab, Atezolizumab, Avelumab, Bevacizumab, Blinatumomab, Brentuximab, Cemiplimab, Cetuximab, Daratumumab, Dinutuximab, Durvalumab, Elotuzumab, Gemtuzumab, Inotuzumab Ozogamicin, Ipilimumab, Mogamulizumab, Moxetumomab Pasudotox, Necitumumab, Nivolumab, Ofatumumab, Olaratumab, Panitumumab, Pembrolizumab, Pertuzumab, Ramucirumab, Rituximab, Tositumomab, Trastuzumab
Protein Kinase Inhibitors
Abemaciclib, Acalabrutinib, Afatinib, Alectinib, Axitinib, Binimetinib, Bortezomib, Bosutinib, Brigatinib, Cabozantinib, Carfilzomib, Ceritinib, Cobimetinib, Copanlisib, Crizotinib, Dabrafenib, Dacomitinib, Dasatinib, Duvelisib, Enasidenib, Encorafenib, Erlotinib, Gefitinib, Gilteritinib, Glasdegib, Ibrutinib, Idelalisib, Imatinib, Ivosidenib, Ixazomib, Lapatinib, Larotrectinib, Lenvatinib, Lorlatinib, Midostaurin, Neratinib, Nilotinib, Niraparib, Olaparib, Osimertinib, Palbociclib, Pazopanib, Pexidartinib, Ponatinib, Regorafenib, Ribocicib, Rucaparib, Ruxolitinib, Selumetinib, Sonidegib, Sorafenib, Sunitinib, Talazoparib, Trametinib, Vandetanib, Vemurafenib, Vismodegib, Zanubrutinib
Taxanes
Cabazitaxel, Docetaxel, Paclitaxel
Topoisomerase Inhibitors
Etoposide, Irinotecan, Teniposide, Topotecan
Vinca Alkaloids
Vinblastine, Vincristine, Vinorelbine
Miscellaneous
Asparaginase (Pegaspargase), Bexarotene, Eribulin, Everolimus, Hydroxyurea, Ixabepilone, Lenalidomide, Mitotane, Omacetaxine, Pomalidomide, Tagraxofusp, Telotristat, Temsirolimus, Thalidomide, Venetoclax
Reference:
https://www.ncbi.nlm.nih.gov/books/NBK548022/
