Antineoplastic Agents
Neoplasm Cancer—Mechanisms of Growth
- Anaplasia
- Cancerous cells lose cellular differentiation and organization and are unable to function normally
- Autonomy
- Cancerous cells grow without the usual homeostatic restrictions that regulate cell growth and control
- This allows the cells to form a tumor
- Metastasis
- Cancer cells travel from the place of origin to develop new tumors in other areas of the body
- Angiogenesis
- Abnormal cells release enzymes to generate blood vessels and supply oxygen and nutrients to the cells, generating growth
- Cancerous cells rob the host cells of energy and nutrients and block normal lymph
The Body’s Immune System Response to Cancerous Cells
- Can damage or destroy some neoplastic cells
- T cells recognize the abnormal cells and destroy them
- Antibodies form in response to parts of the abnormal cell protein
- Interferons and tissue necrosis factor (TNF) play a role in the body’s attempt to eliminate the abnormal cells
Possible Causes of Cancer
- Genetic predisposition
- Viral infection
- Constant irritation and cell turnover
- Stress
- Lifestyle factors
- Environmental factors
Classifications of Tumors
- Solid tumors
- May originate in any body organ
- Carcinomas (originate in epithelial cells)
- Sarcomas (originate in the mesenchyma)
- Hematologic malignancies
- Leukemias and lymphomas that occur in the blood-forming organs
Mechanisms of Antineoplastic Drugs
- Affect cell survival
- Boost the immune system in its efforts to combat the abnormal cells
Goal of Cancer Treatment
- To destroy cancer cells using the following methods:
- Surgical removal
- Stimulation of the immune system to destroy them
- Radiation therapy to destroy them
- Drug therapy to kill them during various phases of the cell cycle
Categories of Antineoplastic Agents
- Alkylating agents
- React chemically with portions of the RNA, DNA, or other cellular proteins
- Antimetabolites
- Have chemical structures similar to those of natural metabolites
- Antineoplastic antibiotics
- Not selective for bacterial cells only; toxic to human cells
- Mitotic inhibitors
- Drugs that kill cells as the process of mitosis begins
- Hormones and hormone modulators
- Used in cancers that are sensitive to estrogen stimulation
- Cancer-cell–specific agents
- Treat chronic myeloid leukemia (CML) and CD117-positive unresectable or metastatic malignant GI stromal tumors (GIST)
Sites of Action of Non-Cell-Cycle–Specific Antineoplastic Agents

Sites of Action of Cell-Cycle–Specific Antineoplastic Agents
Alkylating Agents
- Actions
- Pharmacokinetics
- Contraindications
- Adverse reactions
- Drug-to-drug interactions
Antimetabolites
- Actions
- Pharmacokinetics
- Contraindications
- Adverse reactions
- Drug-to-drug interactions
Antineoplastic Antibiotics
- Actions
- Pharmacokinetics
- Contraindications
- Adverse reactions
- Drug-to-drug interactions
Mitotic Inhibitors
- Actions
- Pharmacokinetics
- Contraindications
- Adverse reactions
- Drug-to-drug interactions
Hormones and Hormone Modulators
- Actions
- Pharmacokinetics
- Contraindications
- Adverse reactions
- Drug-to-drug interactions
Prototype Alkylating Agent

Prototype Antimetabolite Agent

Prototype Antineoplastic Antibiotics

Prototype Mitotic Inhibitors

Prototype Hormones and Hormone Modulators

Use of Antineoplastic Across the Lifespan

Nursing Considerations for Alkylating Agents
- Assessment (history and physical exam)
- Nursing diagnosis
- Implementation
- Evaluation
Nursing Considerations for Antimetabolites
- Assessment (history and physical exam)
- Nursing diagnosis
- Implementation
- Evaluation
Nursing Considerations for Antineoplastic Antibiotics
- Assessment (history and physical exam)
- Nursing diagnosis
- Implementation
- Evaluation
Nursing Considerations for Mitotic Inhibitors
- Assessment (history and physical exam)
- Nursing diagnosis
- Implementation
- Evaluation
Nursing Considerations for Hormones and Hormone Modulators
- Assessment (history and physical exam)
- Nursing diagnosis
- Implementation
- Evaluation