Products for Cancer Treatment

The basic drug product classes used in the treatment of cancer include chemotherapeutics, hormone therapy, biological drugs, and investigational treatments available through controlled clinical trials. The specific product used to treat cancer depends on the type of tumor and tissue/organ of origin, the stage of the cancer and its degree of progression, and whether the cancer has metastasized or spread to other organs, lymph nodes and regions of the body.

Chemotherapy Products

• Chemotherapeutics are drugs that are essentially cytotoxic, killing cells that are undergoing rapid growth and expansion; they are highly effective in killing cancerous cells. Chemotherapy drugs reach all parts of the body, not just the cancer cells, and as such are associated with significant side effects. These drugs can be given in pill form, intravenously or topically. Common agents in this class include platinum-containing drugs (cisplatin, carboplatin), cyclophosphamide, taxanes (taxotere, paclitaxel), cytotoxic antibiotics (doxorubicin), fluorouracil, irinotecan, methotrexate, vincristine and many others that have been used for well over 25 years on a diverse range of advanced cancers.

Hormone-Based Cancer Therapy Products

• Prior to implementing hormone drug therapy a specific series of hormone receptor tests are performed to characterize the tumor and ascertain whether the cancer is hormone-sensitive. Drugs in this class for prostate cancer include finasteride (Proscar), which targets the enzyme that converts testosterone to dihydrotestosterone (DHT); the direct anti-androgen therapies bicalutamide (Casodex), nilutamide (Anandron) and flutamide (Eulexin), which bind to the AR and block androgens from perpetuating tumor growth. The LHRH agonist/antagonists such as leuprolide, goserelin and triptorelin/degarelixIn inhibit testosterone production for diminishing stimulation of prostate cancer. For breast cancer, tamoxifen and toremifene (Fareston) are anti-estrogen drugs working by antagonizing estrogen receptors on breast cancer cells. The aromatase inhibitors stop estrogen production and treat both early and advanced breast cancer; these include letrozole (Femara), anastrozole (Arimidex) and exemestane (Aromasin).

Biological Anticancer Products

• Biological drugs consist of small antibodies (monoclonal antibodies--Mabs) that are used to target specific cell surface receptors and cell signaling pathways known to stimulate cancer cell growth directly. This approach allows for selectively impacting cancer cells to a more refined degree. This class of therapies has evolved since early 2000 and new drugs are being approved annually. Drugs in this class include imatanib (Gleevec) for chronic myeloid leukemia; erlotinib (Tarceva), non-small cell lung cancer and pancreatic cancer; sunitinib (Sutent), renal cell carcinoma and gastrointestinal stromal tumor; sorafinib (Nexavar), renal cell carcinoma and liver cancer; bevacizumab (Avastin), colon cancer; and trastuzumab (Herceptin), breast cancer.

Non-Approved Cancer Products

• At the national and private levels, bringing novel therapies to patients is a concerted drug discovery effort in the U.S. Cancer treatments represent the largest class of innovative products currently being tested in controlled clinical trials with hundreds of different products tested annually. Individuals who fail with traditional first- and second-line treatments and have limited available options are eligible. Drugs that have progressed to a Phase II or Phase III and typically shown promising results in previous trials can be evaluated on clinicaltrials.gov to review criteria for gaining access to new non-approved treatments. In cancer treatment trials patients will always be given standard approved drug treatment for their cancer in addition to either the novel treatment or placebo.

Combining Cancer Products

• Often, a combination of different types of product classes are used to treat a particular type of cancer. Certain drugs also may be given in a specific order depending on the type of cancer or stage followed by other more potent therapeutics. It is necessary to thoroughly investigate the type of drug being employed and to understand its mechanism of action that will allow for a greater sense of control and genuine hope in fighting cancer.