Oncofos
(Cyclophosphamide)
Composition:
ATC Code
L01AA01 — Cyclophosphamide
Structure
Description
Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It has been used in the treatment of lymphoma and leukemia. Its side effect, alopecia, has been used for defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer.
Indication
- Cyclophosphamide is indicated for the treatment of malignant lymphomas, multiple myeloma, leukemias, mycosis fungoides (advanced disease), neuroblastoma (disseminated disease), adenocarcinoma of the ovary, retinoblastoma, and carcinoma of the breast. It is also indicated for the treatment of biopsy-proven minimal change nephrotic syndrome in pediatric patients.
Associated Conditions
- Acute Lymphoblastic Leukaemias (ALL)
- Acute Myelocytic Leukemia
- Adenocarcinoma of the Ovaries
- Autoimmune Hemolytic Anemia
- Breast Cancer
- Burkitt’s Lymphoma
- Chronic Lymphocytic Leukaemia (CLL)
- Chronic Myeloid Leukemia (CML)
- Disseminated Neuroblastoma
- Ewing’s Sarcoma (ES)
- Granulomatosis With Polyangiitis
- Juvenile Idiopathic Arthritis (JIA)
- Lung Cancers
- Lymphoma, Hodgkins
- Minimal Change Nephrotic Syndrome (MCNS)
- Multiple Myeloma (MM)
- Myasthenia Gravis
- Nephritis, Lupus
- Non-Hodgkin’s Lymphoma (NHL)
- Ovarian germ cell tumour
- Pheochromocytomas
- Retinoblastoma
- Rhabdomyosarcomas
- Uveitis
- Waldenström’s Macroglobulinemia (WM)
- Advanced Alibert-Bazin syndrome
- Histiocytic lymphoma
- Metastatic gestational trophoblastic tumor
- Mixed-cell type lymphoma
- Recurrent Pericarditis
- Refractory Small cell lung cancer
- Refractory immune thrombocytopenia
- Relapsed Wilm’s tumor
Pharmacodynamics
Cyclophosphamide is an antineoplastic in the class of alkylating agents and is used to treat various forms of cancer. Alkylating agents are so named because of their ability to add alkyl groups to many electronegative groups under conditions present in cells. They stop tumor growth by cross-linking guanine bases in DNA double-helix strands – directly attacking DNA. This makes the strands unable to uncoil and separate. As this is necessary in DNA replication, the cells can no longer divide. In addition, these drugs add methyl or other alkyl groups onto molecules where they do not belong which in turn inhibits their correct utilization by base pairing and causes a miscoding of DNA. Alkylating agents are cell cycle-nonspecific. Alkylating agents work by three different mechanisms all of which achieve the same end result – disruption of DNA function and cell death.
Mechanism of Action
Alkylating agents work by three different mechanisms:
1) attachment of alkyl groups to DNA bases, resulting in the DNA being fragmented by repair enzymes in their attempts to replace the alkylated bases, preventing DNA synthesis and RNA transcription from the affected DNA,
2) DNA damage via the formation of cross-links (bonds between atoms in the DNA) which prevents DNA from being separated for synthesis or transcription, and 3) the induction of mispairing of the nucleotides leading to mutations.