How Do Antineoplastic Antimetabolites Work?

Antineoplastic antimetabolites are a class of drugs used to treat breast, ovarian, colon, or rectal cancer. They are also used to treat rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function), psoriasis (a skin disease in which red, scaly patches form on some areas of the body), hairy cell leukemia (a rare, slow-growing cancer of the blood in which your bone marrow makes too many B cells [lymphocytes]), chronic lymphocytic leukemia (a type of cancer of the blood and bone marrow), chronic myelogenous leukemia (an uncommon type of cancer of the bone marrow), cutaneous T-cell lymphoma (a rare type of cancer that begins in white blood cells called T cells [T lymphocytes]), peripheral T-cell lymphoma (a form of cancer that begins in a certain type of cells in the immune system), and acute myeloid leukemia (a type of cancer that begins in the white blood cells). 

Antimetabolites belong to a class of medications called “antifolate antineoplastic agents” that work by blocking the action of a certain substance in the body that may help cancer cells multiply.

Antineoplastic antimetabolites are administered intravenously (into a vein) and via oral routes.

Antineoplastic antimetabolites work in the following ways:

They are a type of antibiotics that are only used in cancer chemotherapy.

• They work by slowing down or stopping the growth of cancer cells.
• They work by suppressing the immune system to reduce joint damage in rheumatoid arthritis.
• They belong to a class of medications called “folate analog metabolic inhibitors” that work by killing cancer cells and limiting the development of new cancer cells.
• They help in treating psoriasis by slowing down the growth of skin cells and prevent scale formation.

Antineoplastic antimetabolites are used to treat conditions such as:

• Chronic lymphocytic leukemia (a type of cancer of the blood and bone marrow)
• Hairy cell leukemia (a rare, slow-growing cancer of the blood in which your bone marrow makes many B cells [lymphocytes])
• Acute graft-versus-host disease (a condition that might occur after an allogeneic transplant)
• Acute lymphatic leukemia (a type of cancer that begins in the white blood cells)
• Chronic myelocytic leukemia (an uncommon type of cancer of the bone marrow)
• B-cell chronic lymphocytic leukemia (a malignancy of CD5+ B cells)
• Non-Hodgkin’s lymphoma (tumors develop from the lymphocytes)
• Peripheral T-cell lymphoma (a form of cancer that begins in a certain type of cells in the immune system)
• Crohn’s disease (a condition that causes the digestive tract to become swollen and irritated)
• Acute nonlymphocytic leukemia (a quickly progressive malignant disease in which there are many immature blood-forming cells in the blood and bone marrow)
• Acute myelogenous leukemia (a type of cancer that starts in the blood-forming cells of the bone marrow)
• Acute myeloid leukemia (a cancer of the blood and bone marrow)
• Colon and rectum cancer
• Gastric cancer
• Pancreatic cancer
• Colorectal cancer
• Ovarian cancer (cancer that begins in the female reproductive organs where eggs are formed)
• Osteosarcoma (a type of bone cancer that begins in the cells that form bones)
• Gestational trophoblastic neoplasia (a type of tumor that forms inside a woman's uterus while she is pregnant)
• Rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function)
• Psoriasis (a skin disease in which red, scaly patches form on some areas of the body) 
• Glioblastoma multiforme (an aggressive type of cancer that begins in cells called astrocytes that support nerve cells)
• Mesothelioma (a type of cancer that develops from the thin layer of tissue that covers many internal organs)
• Nonsquamous non-small cell lung carcinoma
• Relapsing forms of multiple sclerosis (a potentially disabling disease of the brain and spinal cord)
• Meningeal leukemia (cancer in the membrane that covers and protects the spinal cord and brain)
• Lymphomatous meningitis (a type of neoplastic meningitis)
• Gliomas (a type of brain tumor that originates from glial cells, which help support the function of the other main brain cell type—the neuron)
• Head and neck tumors
• Sickle cell disease (a group of inherited red blood cell disorders)

Some of the common side effects include:

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Headache
• Tiredness/weakness
• Mouth sores
• Loss of appetite
• Constipation
• Dry/itchy skin
• Pain, redness, swelling, hardness, or itching at the injection site
• Pale skin
• Flushing
• Pain in the back, joints, arms, or legs

Other rare side effects include:

• Dizziness 
• Insomnia (trouble falling and/or staying asleep)
• Fatigue 
• Weight loss
• Hair loss
• Night sweats
• Shortness of breath
• Tachycardia (fast heartbeat)
• Chills, sore throat, fever, or cough
• Thrombocytopenia (low blood platelet count)
• Anemia (low red blood cell count)
• Blurry vision
• Decreased or painful urination
• Chest pain
• Swelling of the hands, feet, ankles, or lower legs
• Extreme thirst
• Pain, burning, or tingling in the hands or feet
• Rash, itching, hives
• Yellowing of the skin or eyes
• Seizures (a sudden, uncontrolled electrical disturbance in the brain)
• Confusion
• Depression
• Irritability

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of antineoplastic antimetabolites include:

• 2Deoxycoformycin
• 6Mercaptopurine
• 6MP
• 6TG
• 6Thioguanine
• Adrucil
• Alimta
• Arranon
• Capecitabine
• Cladribine
• Clofarabine
• Clolar
• Cytarabine
• Cytarabine/daunorubicin liposomal
• Cytosar U
• DCF
• Droxia
• Floxuridine
• Fludara
• Fludarabine
• Fluorouracil
• Folotyn
• FUDR
• Gemcitabine
• Gemzar
• Hydrea
• Hydroxycarbamide
• Hydroxyurea
• Infugem
• Leustatin DSC
• Mavenclad
• Mercaptopurine
• Methotrexate
• Nelarabine
• Nipent
• Oforta
• Otrexup
• Pemetrexed
• Pemfexy
• Pentostatin
• Pralatrexate
• Purinethol
• Purixan
• Rasuvo
• RediTrex
• Siklos
• Tabloid
• Thioguanine
• Trexall
• Vyxeos
• Xatmep
• Xeloda