Weighing the Pros and Cons of Antineoplastic Drugs (2024)

Antineoplastic drugs are medicines used to treat cancer and other diseases. It’s a general name for drugs that stop tumor cells from growing and dividing. Antineoplastic drugs are also called anticancer drugs, chemotherapy, cytotoxic drugs, oncology drugs, and cancer drugs.

The goal of antineoplastic drugs in cancer treatment is to stop or block the growth of cells in a tumor. These drugs may also treat arthritis, multiple sclerosis, benign (noncancerous) tumors, and other noncancer medical conditions.

This article includes a list of common types of antineoplastic drugs, with examples. It discusses the basics of antineoplastic drug side effects. It describes the differences and similarities among antineoplastic medications, chemotherapy, and immunotherapy.

Is Antineoplastic the Same as Chemotherapy?

"Neoplasia" is another word for "abnormal and uncontrolled cell growth." Tumors develop when cells grow and divide when they’re not supposed to. A neoplasm can be cancerous (malignant) or not (benign).

Malignant tumors, also called cancers, grow into nearby tissues and sometimes spread to other parts of the body.

An antineoplastic is any drug or treatment that kills or stops tumor cells from growing. They can include radiation treatments and biologics, including immunotherapy and targeted therapy.

Chemotherapy drugs are one type of antineoplastic drug. Not all antineoplastic drugs are chemotherapy, but all chemotherapy drugs are antineoplastic drugs.

More than 1,900 antineoplastic drugs are cataloged in the National Cancer Institute’s SEER RX (Surveillance, Epidemiology, and End Results) database.

Uses During Treatment

If a healthcare provider suggests treatment with antineoplastic drugs, these drugs will be tailored to your tumor, cancer, or disease.

Antineoplastic drugs can be used in combination with each other and with other procedures, like surgery. For example, radiation and chemotherapy are often used together.

They are often used before or after surgery or paired with other antineoplastic treatments like immunotherapy, targeted therapy, or hormone therapy. The timing of antineoplastic therapy during cancer treatment includes:

• Neoadjuvant therapies, including chemotherapy or radiation, are given before a person gets surgery to remove a tumor.
• Adjunct therapies are given simultaneously (for example, chemotherapy and radiation simultaneously).
• Adjuvant therapies are given after surgery to shrink or kill any remaining tumor cells and reduce the risk of cancer coming back.

The specific combinations of antineoplastic drugs your healthcare provider recommends will be based on your disease, how advanced it is, your general health, and how you have reacted to previous treatments.

Antineoplastic Drug List and Types

Antineoplastics are a large group of medicines and treatments. They have many different chemical forms and work in different ways. There are multiple ways to characterize them.

Scientists sometimes characterize them by their chemical makeup or mechanism of action. They may be divided up by the types of cancer they treat.

Generally, drugs that treat cancer fall into five types, as follows:

• Chemotherapy
• Radiation
• Targeted therapy
• Immunotherapy
• Hormone therapy

One way of classifying antineoplastics is by how they work generally. They may be called nonspecific or targeted.

Nonspecific antineoplastics attack any fast-growing cells in the body, including cancer cells. This is typically how chemotherapies and radiation work. These agents are not specific to cancer cells.

Chemotherapy

Chemotherapy drugs stop the growth of actively dividing cells and often kill them. Chemotherapy comes in many forms, including:

• Alkylating agents: These interfere with DNA replication. Examples include Busulfex (busulfan), Cytoxan(cyclophosphamide), and Platinol (cisplatin)
• Antimetabolites: These interfere with DNA and RNA synthesis. Examples include Ara-C (cytarabine), Efudex (5-fluorouracil), and Trexall (methotrexate)
• Antitumor antibiotics: These interfere with the production of RNA and DNA. Examples include Adriamycin (doxorubicin), Blenoxane (bleomycin), and Cerubidine (daunorubicin).
• Topoisomerase and mitotic inhibitors (also called plant alkaloids): These stop cell division. They include Oncovin (vincristine sulfate), Taxol (pacl*taxel), and VP-16 (etoposide).
  

Radiation Therapy

Radiation is a focused beam of energy from an object or fluid inserted into the body (called radiopharmaceuticals or radionuclides) or from a machine outside the body. The energy kills cells in the area in a nonspecific way, meaning it kills all cells in an area.

Common types of radiation treatment include:

• External beam
• Internal radiation (brachytherapy)
• Oral or systemic radiation (radiopharmaceuticals)

Radiation therapy drugs include:

• Radioactive iodine
• Xofigo (radium 223 dichloride)
• Pluvicto (lutetium Lu 177 vipivotide tetraxetan)

Targeted Therapy

Targeted therapy uses the tumor cells' characteristics, like the proteins they make, to find and kill cancer. These drugs include:

• Angiogenesis inhibitors
  
• Proteasome inhibitors
• Signal transduction inhibitors, including kinase inhibitors

Some common examples of targeted antineoplastics include:

• Avastin (bevacizumab)
• Velcade (bortezomib)
• Gleevec (imatinib)
• Erbitux (cetuximab)

Immunotherapy

Immunotherapy uses the body’s own immune system to attack and kill cancer. This may be done in a targeted way. Often these drugs (and other targeted therapies) are monoclonal antibodies, a copy of our immune system’s anti-invader proteins created outside the body.

Types of antineoplastic immunotherapy include:

• Immune checkpoint inhibitors
• Oncolytic virus therapy
• T-cell therapy
• Cancer vaccines

Standard antineoplastic immunotherapies include:

• Keytruda (pembrolizumab)
• Opdivo (nivolumab)
• Yervoy (ipilimumab)

Hormone Therapy

Hormone therapy changes the body’s hormones to stop the growth of cancer cells that use them to grow. Examples of antineoplastic hormone therapy include:

• Aromatase inhibitors
• Selective estrogen receptor modulators
• Antiandrogens

Standard hormone therapies include:

• Soltamox (tamoxifen)
• Arimidex (anastrozole)
• Erleada (apalutamide)

Benefits vs. Drawbacks

The benefit of antineoplastic drugs is their ability to kill tumor cells, including cancers, and treat other diseases, like autoimmune diseases.

Your best chance of beating a disease like cancer is following your healthcare provider's suggestions. Get a second opinion if you're unsure of your oncologist's treatment plan. If you have questions about their choices, ask them.

But antineoplastic treatment can be grueling, long, and have side effects that make daily life challenging. You may need to take time off from your job to get and heal from cancer treatment.

The side effects of certain antineoplastic drugs can be hard to deal with. Discuss your treatment plan with your care team if you have problematic side effects. Talk to a palliative care specialist about your treatment choices and if they match your treatment goals.

Depending on the type of cancer and how advanced it is, these treatments aren't always helpful. It's possible that even with prolonged, aggressive treatment, cancer may win. These aggressive treatments can take time away from your loved ones, strain your mental and physical health, and cause side effects and complications.

Cancer treatment also is costly. The cost of care for the first year of a cancer diagnosis is over $45,000 on average. In the last year of life, it's over $100,000.