Anticancer drug II: Hormonal agents, biologic response Modifiers, and targeted drugs Gonodotropin- releasing hormone agonist

Mechanism of action: It suppresses the production of androgens by the testes. They can be looked on as indirect- acting antidrogens. Example drugs: Leuprolide Triptorelin Goserelin Nafarelin

Mnemonics: Love Triangle God Na. Antiestrogens Mechanism of action: It is the drug that blocks the estrogen receptors and hence only work against cells that are ER positive. Benefits derive from depriving tumor cells if the growthpromoting influence of estrogen. Example drugs: Bicalutamide Tamoxifen Raloxifene Fulvestrant

Mnemonics: Bi Tarafu Aromatase Inhibitors Mechanism of action: Used to treat ER- positive breast cancer in postmenopausal women. These drugs block the production of estrogens from androgenic precursors and thereby deprive breast cancer cells of the estrogens they need for growth. It will not block production of estrogens by the ovaries hence it will give little benefits to the premenopausal women. Example drugs: Anastrozole Letrozole Exemestane

Mnemonics: ALEx

Target anticancer drugs Are designed to bind with specific molecules that drive growth. These drugs will be more selective than hormones and cytotoxic anticancer drug and hence it will able to destroy cancer cells while leaving normal cells untouched. EGFR-Tyrosine kinase inhibitors Mechanism of action: the receptor portion of EGFR, which is found on the outer surface of the cell membrane, is coupled with TK on the inner surface of the cell membrane. Binding of antagonist to EGFR activates TK, which in turn activates signalling pathway that regulate cell proliferation and survivals. Example drugs: Cetuximab Panitumumab Erlotinib Gefitinid Mnenomics: C PEG BCR-ABL Tyrosine inhibitors Mechanism of action: it is preferred agents for treating myeloid leukaemia. This inhibitor activates as yet unidentified regulatory proteins which in turn inhibit apoptosis and stimulate excessive cell proliferation. Example drugs: Nilotinib Dasatinib Imatinib

Mnemonics: Notre Dame Immaculate CD20-directed antibodies Mechanism of action: it will trigger the immune attack against the B-cell itself. Example drugs: Rituximab Ibritumomab Tositumomad

Mnemonics: Right In Truth

Angiogenesis inhibitors Mechanism of action: suppress the formation of the new blood vessels and thereby deprive the solid tumors of the expanding blood supply they needed to continue growth. However the growth of the tumor suppress, these inhibitor ca not kill the tumor cell that already exist. Example drugs: Bevacizumab