Cytostatics (overview)

Substances from different classes of active ingredients, which have an antineoplastic effect. In the narrower sense, the term "cytostatic drugs" is used to describe conventional non-selective cytostatic drugs which use a broad spectrum of non-selective substances to inhibit the growth of proliferating cells, i.e. tumour cells, but also of healthy cells with a high proliferation rate (see side effects, see also antineoplastic tumour therapeutics).

Classification of conventional (non-selective) cytostatic drugs:

Antimetabolites

• Folic acid analogues
  • Methotrexate
  • Pemetrexed
• Purine analogues
  • 6-mercaptopurine
  • Pentostatin
  • Cladribine
• Pyrimidine analogues
  • 5-fluorouracil (inhibits thymidilate synthase)
  • Capecitabine (prodrug from 5-FU)
  • Tegafur (prodrug from 5-FU)
  • Gemcitabine
  • Cytarabine

Alkylating cytostatics (alkylantics)

• Nitrogen Lost Derivatives (Lost = abbreviation of the names of the developers Lommel and Steinkopf)
  • Cyclophosphamide
  • Trofosfamide
  • Ifosfamide
  • Chlorambucil
  • Melphalan
• Ethyelnimines
  • Thiotepa
• Nitrosourea
  • Carmustine (BCNU)
  • Lomustine (CCNU)
  • Fotemustin
• Platinum Analogues
  • Cisplatin
  • Carboplatinum
  • Oxaliplatin
• Other alkylating substances
  • Procarbazine
  • Dacarbazine
  • Temozolomide

Topoisomerase inhibitors

• Topotecan (inhibitor of topoisomerase I)
• Irinotecan (inhibitor of topoisomerase I)
• Etoposide (inhibitor of topoisomerase II)
• Teniposide Glycoside of podophyllotoxin (inhibitor of topoisomerase II)

Mitosis inhibitors

• Vinca alkaloids
  • Vinblastine
  • Vincrist
  • Vindesin
  • Vinorelbine
• Taxanes
  • Paclitaxel
  • docetaxel
  • Cabazitaxel

Cytostatically effective antibiotics

• Daunorubicin
• Doxorubicin
• Bleomycin
• Epirubicin
• Idarubicin
• Mitoxantrone

Other cytostatic drugs

• Asparaginase
• Hydroxyurea
• radium-223 dichloride

Frequent cutaneous side effects caused by cytostatic drugs (var. n. Pfützner W 2018)

• Bleomycin: flagellant dermatitis, neutrophil eccrine hidradenitis, alopecia, radiate recall dermatitis, Beau-Reils transverse furrows, melanonychia
• Cisplatin: hand-foot syndrome, spotty (pressure-related) hyperpigmentation, leukonychia, Beau-Reilsche transverse furrows
• Cyclophosphamide: hand-foot syndrome, stomatitis, spotty (pressure-related) hyperpigmentation, leukonyony, Beau-Reils transverse furrows, neutrophil eccrine hidradenitis, radiotestinal recall, hyperpigmentation, alopecia, hair discoloration (red-black), Beau-Reils transverse furrows, Mührke lines, leukony
• Cytarabine: hand-foot syndrome, neutrophil eccrine hidradenitis; alopecia, radiographic recall, Beau-Reilsche transverse furrows, leukonychia
• Dacarbazin: phototoxicity, alopecia, hyperpigmentation
• Daunorubicin: alopecia, neutrophil eccrine hidradenitis; alopecia, radiate recall, Beau-Reile's transverse furrows, Meese's bands, melanonychia,
• docetaxel, paclitaxel: exanthema, hand-foot syndrome, alopecia, neutrophil eccrine hidradenitis, pseudoscleroderma, radiotactic recall, Beau-Reils transverse furrows, onycholysis, hyperpigmentation, irritated actinic keratoses
• Doxorubicin: exanthema, hand-foot syndrome, alopecia, neutrophil eccrine hidradenitis, pseudoscleroderma, radiotestinal recall, Beau-Reils transverse furrows, onycholysis, hyperpigmentation (face, buccal mucosa, tongue, throat, hands), phototoxicity, irritated actinic keratoses
• Fluorouracil: hand-foot syndrome, alopecia, neutrophil eccrine hidradenitis, pseudoscleroderma, radiotestinal recall, Beau-Reils transverse furrows, onycholysis, scleronychia, hyperpigmentation (face, buccal mucosa, tongue, neck, hands), irritated actinic keratoses, phototoxicity
• Gemcitabine: exanthema, stomatitis, alopecia, pseudoscleroderma, onycholysis, radiotestinal recall, scleronychia
• Hydroxyurea: Lichenoides exanthema; hand-foot syndrome, ulcers, radiant recall, hyperpigmentation (face, buccal mucosa, tongue, neck, hands), phototoxicity, alopecia, onycholysis
• Methotrexate: hand-foot syndrome, ulcers, alopecia, radiant recall, Beau-Reils transverse furrows, onycholysis, UV recall; hyperpigmentation (face, buccal mucosa, tongue, neck, hands), phototoxicity, hair discoloration (lightening)
• Vinca alkaloids: hand-foot syndrome, stomatitis, radiant recall, alopecia, Beau-Reils transverse furrows, leukonychia

Note: except for acute toxic extravasations, immunological hypersensitivity reactions

S.a. Common toxicity criteria.

1. Puddle W (2018) Cutaneous drug reactions. In: G.Plewig et al. (Ed.) Braun-Falco`s Dermatology, Venerology and Allergology, Springer Reference Medicine p.617